Homestead_Dearing H. PREPARER
Preparer of the Sales Disclosure Form Title
Cody L Pruett Closing Agent
Company
Address(number and street,city,state,country,and ZIP Code)
4600 Washington Ave., Suite 102, Evansville, IN 47714
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveya,'••• .• ument
Jose A.Villeda Escobar -
Address(number and street) Address(number and street) ,
/ 4 F Mar�C ,f)1',
Cityt 4,1
state,and ZIP Code City,state,and ZIP Code ✓(/N
t� r/e rd IV• e 2 d 2.� '41)
Country I
Country '�
ge0Ce fr %s ue 1��3@...1
E-mail address
of my knowledge and belief,is tru 49 a d complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifie iue of transferred
real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.
Sign Sel Signature of Seller
nt Name of Seller Date signed(mrrr/dd/yyyy) Printed Name of Seller Date signed(mmlddlyyyy)
Jose A. Villeda Escobar O 6- Q.3 r. __
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
Chris Dearing Rilee Dearing
Address(number and street) Address(number and street)
14 5 L. ;Acel n S )- Gtv t. _I14z. ncatn sk
City,state,and ZIP Code City,state,and ZIP Code
04 I,-1,,,J CH'f! r N >4 l LC o ( ! ild rI - t4 `f7b
Country Country
E-mall dress' Telephone number E-mall ddress
YES NO CONDITION E NO CONDITION
D 1.Will this property be the buyer's primary D 3.Homestead
residence? El O 4.Solar Energy Heating or Cooling System
0 . 2. Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
for this residence? If yes,provide address: 0 p 6.Hydroelectric Power Device
Address(number and street) 0 J 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county q '-‘4'- S--LOX
_00 0, 001-004
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct and complete
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