Homestead_Washington 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
J&J Heartland Hills LLC
-Address(number and street) Address(number and street�.1
I Li 2V 57 j.�wy tt r
City,state,and ZIP Code City,state,and ZIP Code
LYArN v I(.(.r 1.-,-/ 4 76 M 4,&,i)
Country Country QC,
,2
E-mail address
Q/e pQ ( )
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowf�(keli,ull,f, - true,corre { 'Complete as
required by law,and Is prepared In accordance with IC 6-1.1-5.5.A person who knowingly an •' , falsifies the v u transferred
real property,or omits or falsifies any Information required to be provided,commits a Level 5 felon .,qii -_•
,
Signal of S lieSignature of Seller 40/TO
Prirr'd Name bf Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mmiddlyyyy) '
Jacob Duncan, Sole Member 0'2 . ./ 3
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
Ron Sharron Washington Jr.
Ads'(number and stree h + Address(number and street)
City,state,and ZIP Code 1 II City,state,and ZIP Code
Pr ,r`:.2}on N Lflt lD
Country Country
E-mail address
( )
Pursuant to IC 8-1.1-12-44,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 O 1.Will this property be the buyer's primary
residence? 0 3. Homestead
0 O 4.Solar Energy Heating or Cooling System
® O 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence? If yes,provide address: 0 O 6. Hydroelectric Power Device
Address(number and street) 0 ( 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county ! _ \\- 12--/ ,O Z-ioz-0" -Q 2
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct and complete