Homestead_Dillon (3) Preparer of the Sales Disclosure Form Title I
I Amy B. Pollard Settlement A_gent
Company
Address(number and street,city,state.country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I. SELLERS)/GRANTOR(S) •
_ _ _ __ _ _ ___ __ •
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on cony document
BWS Residental LLC _
Address(number and street) Address(number and street)
970 W 1150 S
City.State,and ZIP Code City. State.and ZIP Code 4116•n i
Ladoga,IN 47954 w
Country Country G,/"S
?3
US '�
ti7). , )
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is trS>�,90 -• •,and complete as
I required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifieQOie value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. �!
Sign f eller Signature of Seller
/ iS$
Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
William Woods, 08/04/2023 08/04/2023
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
Blake Dillon
Address(number and street) Address(number and street)
107 Breckenridge Street
City,State,and ZIP Code City.State, and ZIP Code
Monroe City,IN 47557
Country Country
US
( )
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
1. Will this property be the buyer's primary O 3. Homestead
'fit' O residence? 0 ® 4. Solar Energy Heating or Cooling System
�2. Does the buyer have a homestead to be vacated Q ® 5.Wind Power Device
Q for this residence? Ifyes, provide address:
Q ® 6. Hydroelectric Power Device
Address(number and street) 0 IN 7. Geothermal Energy Heating or Cooling Device
City.State,and ZIP Code County
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
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