Homestead_Ward (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Jan Dobbyn Settlement Agent
Company
Address(number and street,oily,state,country,and ZIP Code)
412 E. Flora St,Washington,IN 47501
I. SELLERS)/GRANTOR(S) 1
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on convey u ant
Judy A.Tryon
Address and�fr L / Irk\ q
( Address(number and street) OnT
City,slate,and ZIP Code C~�)�J` ' ,41)
l �l I City,state,and ZIP Code Cam, ( ! 28
Princeton,IN 47670 �,` ��?? \
Country Country BSON /J
US CD�Q > ��
E-mail address
4q�07,
'''J ctht
Under penalties of perjury,1 hereby certify this Sales Disclosure,to the best of my knowledge and belief,Istrue,corrend complete as
r 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.
SIgnaluie of Seller ,i �,x-/' / ` Signature of Seller
;1 Printed Name of Seller Date signed(mmtddlyyyy) Printed Name of Seiler Date signed(mm/dd/yyyy)
Judy A.Tryon 03/23/2023 - 03/23/2023
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
Crystal Ward
Address(number and street) ` I Address(number and street)
C- s�\and Zr nIP � ) ��, �� City,state,and ZIP Code
Country l X•� Country
( )
Pursuant to IC 6-1.1.12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify aft of those that apply:
YES NO CONDITION ES NO CONDITION
O 1.Will this property be the buyer's primary 0 3.Homestead
residence'? 0 D 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
O for this residence?If yes,provide address:
0 12 6.Hydroelectric Power Device
Address(number and street) 0 D 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
6?6 -0_19 - 3oo- ool. q93-002-7
Under penalties of perjury,I hereby certify that this Sates Disclosure,to the best of my knowledge and belief,is true,correct and complete
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