Homestead_Dixon H. :PREPARRi
. .
Preparer of the Sales Disclosure Form . Tilts
_____________. ....„„+-,, Sett,lement Agent _
-
Company
-Address Ottmbe'r and streot;cily;:state,country,and 21P Code)
519 Main Street, Jasper,IN 47546
,.
L SELLERNIGRANToR(s) .
Seiler 1-Name as it appears on conveyance document
Sailer 2-Nam w,',aPPears on convey.J elo ent Debora Good
Address(number and street)
Address(number and street)
1 211 Dale St
4/6 •
. -
City,Slate.and ZIP Code
City,state,and ZIP Co54,
LOaldand City, IN 47660
s'Y<S
Country
Country
US
— /1/
COC,
A,
E-mail address
best of my knowledgo and ballot Is tree oct and complete as•
required by law,and Is prepared in accordance With IC 6-1,1.54 A person who.knowingly and intentiOnally falsifies the value of transferred
real prPPerty,or omits or-falsities any informati.on required to be Provided,commits a Level 6 felony. • -
,I.SajhRtite c5f'Sellefi'4%-i-t I Signature of Seller
r .
Prinie Name of Seller late signed orpnvdoiyy) Panted Name of Saco — ! Date slned(rnini(ld/yr/Y)
Debora Good 04/14/2023
: 04/14/2923
-,- —
• --
J. BUYER(PWQRANTEE(S)—APPLICATION FOR.PROPERTY TAX DEDUCTION -IDENTIFY ALL THAT APPLY
Buyer 1 Name- as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Taylor R. Dixon
___
Address(number and street)
i Address(numberand street)
211D Ashton Court,Apartment 1
City,stale,anti ZIP Code
. City,stets.arid Code
Princeton, IN 47E70
I I
Country
Counby
US
US
Email address
NO CONDITION
...
El 0 i.Will this property be the buyer's primer), , 0 0 3.Homestead
residence?
0 Ex 4, Solar Energy Heating Or Cooling System
a
2. DZIWINVIA1P-474favalailiptiieMA,1914#,:oczited. . 0 N 5>Wind'Power Device
Oil ;,(Qatb-(014eNti6AMOIRY.k1A-944094.2.;...w3 D CRI 6. Hydroelectric Power Device
A.(154k.s.blif,t*fziaadAtrevA6,,,,i
0 (N 7. Geothermal Energy Heating or Coaling Device
;:,stateoZliiIimedendicie..K.04,)
%--14-a-304-000 . 01-007-
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$ ••• '5,, 4 4,