Homestead_Williamson (2) H. PQERARER
pnapuerofthe Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
Company
Address (number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
|. SELLEN(S)/GRANTOR(S)
Seller 1 -Name aoit appears on conveyance document Seller 2-Name anit appears on conveyance document
Lance C.A|atnn Lauren L.A|otnn
Address (number and street) Address (number and street)
201 S. Race St. 201 G. Race St.
City, State and ZIP Code City, State and ZIP Code
Haubu(adt. |N 47630 Houbxbodt. IN 47638
Country Country
United States ofAmerica United States ofAmerica
E-mail address mail address
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 transferred
real property,or its or falsifies any info7ation required to be provided,commits a Levo|sfo|ony. ~
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' --r////��o nm//o ofSo||or Da10 nigned (mm/dd/yyy me ofGn|/�, Date signed (mm/dd�yyy)
Lance C.A|ston 6/28/2023 L',�auren L. 6/28/2023
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
Blaine R.Williamson Cassandra LWilliamson
Address (number and street) Address (number and street)
3937E. 550G. 3937E. 550G. 0
City. State and ZIP Code City. State and ZIP Code �
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Fort Branch, IN 47648 Fort Branch, IN 47648 r�l �`��<
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Country Country w� �
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United States ofAmerica United Sto\ao of America �J:z
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[7 Pursuant ho |CO4.142'44' the Sales Disclosure Form may be,used to apply for cn�aindeducUpns. /genbfyaUof tioswthatapply: mw
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YES NO CONDITION YES NO CONDITION
L` 2 O 1. Will this property bo the buyer's primary residence? E5 O` 3. Homestead
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EO O 2 Duoo1hobuy�rhovoohomeuk�od0nbovano1odfor -' - - '
' 1 O B 5 VWnd Power Device
ED this residence? |f yes, provide address: '
O ED G. Hydroelectric Power Device
' Address (number and street) '
O GO 7. Geothermal Energy Heating or Cooling Device
3937E. 550 S.
/ City, State,ZIP county
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Fo�Branoh. |N 4784D Gibson ����~'� `^^^ ���~r - �����~ �//*_-.�~-�,
� Under penalties of perjury, |hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct and complete
as required by|uw'and is prepared in accordance with |C 6'1.1'5.5.A person who 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. (Note:Both spouse's
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