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Homestead_Allen H. PREPARER Preparer of the Sales Disclosure Form Title Payge Marx Escrow Officer Company Address(number and street,city,state,country,and ZIP Code) 7412 Eagle Crest Blvd Evansville, IN 47715 I. SELLERS)/GRANTOR(S) . . Seller 1—Name,as it appears on conveyance document Seller 2—Name as appears on coc ment Lydia Elizabeth Dixon Address(n ber and street) Address(number and street) �si5L(0 `\c.Z�L Cr U\)QA' 1C [l e :EN -tip City,state,and ZIP ode City,state,and ZIP Code �QI? / c(�7 7015 ?©23 Country Country US US 0/e8 0 E-mail address knowingly and intentionally falsifies the value of transferred real property,or omits or falsifies any Information required to be provided,commits,a Level 5 felony. '. , SignaCo f Se er, y---4\,.... Signature of Seller Printed'N a of Seller (/r✓ Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) Lydia Elizabeth Dixon 03/13/2023 .J. BUYER(S)/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 Zachery Allen Address(number and street) Address(number and street) 1008 South Race Street City,state,and ZIP Code City,state,and ZIP Code Princeton, IN 47670 Country Country for certain deductions.Identify all of those that applyi YES NO CONDITION YES NO CONDITION 1.Will this property be the buyer's primary O 0 3. Homestead O O residence? O O 4. Solar Energy Heating or Cooling System 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device ` O for this residence?If yes,provide address: 0 0 6. Hydroelectric Power Device Address(number and street) 0 Q 7. Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county rlr, b `'� 02=000. 121-016 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 Last 5 of SSN: Page 3 of 5 >i r t ?�