Homestead_Reyes (3) 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. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Ranvil A. Dillon Donna J. Dillon
Ad`resl(nnuumbfr and rstreet)I N N ` Address(number and street) ,
I 4d II
Gay,state,and ZIP Code H�6 Cjy.. late,and ZIP Code
r
s IN
Countrycis� t f,l�,r'/1 6eT U)'t i f� ''?/�/6 /0 ,
Country
E-mail ress
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 felo
Sign lure of Seller �n Si a re of Seller t
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Se r) Date signed(mm/dd/yyyy)
Ranvil A. Dillon S- d$— '.3 Donna J. Dill 9-28-2023
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
David D. Reyes Elsa S. Reyes
Address(number and street) Address(number and street)
629 W Makemson Ave 629 W Makemson Ave
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670 Princenton, IN 47670
Country Country
E-mail address
YES NO CONDITION YES NO CONDITION
O 1.Will this property be th buyer's primary O 0 3. Homestead
residence? 0 O 4.Solar Energy Heating or Cooling System
0 2.Does the buyer have a h ead to be vacated 0 O 5.Wind Power Device
for this residence? If yes,p e ad s: 0 O 6. Hydroelectric Power Device
Address(number and street)' QQ *6 0 p 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,ari�e.;,1 ty �jI j
sn q2.; a6^(2,- l - l03 -
000- g2) — d 21
Under penalties of perjury,I46-1• • rtify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct and complete
as required
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