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Homestead_Martin (7)
H. PREPARER Preparer of the 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 I. SELLER(S)/GRANTOR(S) Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on conveyance document Blaine R.Williamson Cassandra L.Williamson Address(number and street) Address (number and street) 3937E 550 S 3937E 550 S City, State and ZIP Code City, State and ZIP Code Fort Branch, IN 47648 Fort Branch, IN 47648 Country Country United States of America United States of America E-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 omits or falsifies any information required to be provided,commits a Level 5 felony. Signature of Seller , Si nature of Seller i ..6 .irl Printed Name of Kiler Date signed (mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy) 9 YYYY Blaine R.Williamson 6/23/2023 Cassandra L.Williamson 6/23/2023 J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT y PLY Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on co,v y ce,•ocument Tyler Martin . ' Address (number and street) Address (number and street) ��✓(� 7837 S 45 E cc 0 City, State and ZIP Code City, State and ZIP Cod�0O o Fort Branch, IN 47648 , 4'CO c /10 Country Country °4'i3, ' United States of America -v4 Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply: YES NO CONDITION YES NO CONDITION El ❑* 1. Will this property be the buyer's primary residence? © ❑ 3. Homestead 0 © 4. Solar Energy Heating or Cooling System RI 0 2. Does the buyer have a homestead to be vacated for 0 El 5. Wind Power Device this residence? If yes, provide address: 0 RI 6. Hydroelectric Power Device Address (number and street) 0 RI 7. Geothermal Energy Heating or Cooling Device 7837 S 45 E City, State, ZIP code, and county Fort Branch, IN 47648 Gibson 40-19_j I -f QO- nO - IS-CD 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 transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. (Note:Both spouse's 3 X '