Homestead_Suarez H. PREPARER —'-
Preparer of the Sales Disclosure Form Title
Kandace Rogers Closing Agent
Company
Address(number and street,city,state,country,and ZIP Code)
4905 Theater Drive, Evansville. IN 47715
I. SELLER(S)/GRANTOR(S) _-
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance d
Estate of John H. Block
Address(number and street) Address(number and street)
City,state,and ZIP Code City,state,and ZIP Code 44
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Country Country 02 �Q��
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Telephone number E-mail address Gam...
E-mail address sphone number
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Under penalties of perjury.I hereby certify this Sales Disclosure,to the best of my knowledge and belief.is true.cG ' nd complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies t e of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signature of Seller Signature of Seller
Printed Name of Seller
Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
January 19, 2023
Jayson Block,Personal Representative January 19, 2023 -
J. BUYERS)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Bionery Suarez Pedro Miguel Ferreira
Address(number and street) Address(number and street)
312 Ivy Lane 312 Ivy Lane
City,state,and ZIP Code City,state,and ZIP Code
Owensville, IN 47665 Owensville, IN 47665
Country
Country USA
USA Telephone number
YES NO CONDITION YES NO CONDITION
0 ❑ 1.Willthisproperty be the buyer's primary
❑ 3.Homestead
residence? D 0 4.Solar Energy Heating or Cooling System
El 0
2.Does the buyer have a homestead to be vacated CI 5.Wind Power Device
for this residence?If yes,provide address: ❑ 0 6.Hydroelectric Power Device
Address(number and street) ❑ Q 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 9 Ai _ 0 k_yo'L _o o 0. U.i 3-+D ZZ
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
as required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of
copy