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Homestead_Baylor III H. PREPARER - � 1 Preparer of the Sales Disclosure Form Title Sherri Hudson Settlement Agent Company Email Address Address(number and street,city,state,country,and ZIP Code) 2301 N.Burkhardt Road, Evansville, IN 47715 I.SELLER(S)/GRANTOR(S) Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document i Misty D.Workman Jason K.Blackard E Address(number and street) Address(number and street) 805 E.Walnut St. 805 E.Walnut St. City,State,and ZIP Code City,State,and ZIP Code Fort Branch, IN 47648 Fort Branch, IN 47648 Country Country US US -- — 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 -..' .,roperty,or omits , . ' -. ' Si re f Seller Sign tune of Seller ( Prin ed N e of Seller Date Signed(mm/dd/yyyy) Prr d Name of Seller I Date Signed(mmldd/yyyy) Misty D.Workman 11/09/2023 l J:son K.Blackard pi, l 111109/2023 J. BUYERS)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS IDENALL Ii PPLY Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appca ca ccr:veya, mc. John Franklin Baylor IN 0/ / Address(number and street) Address(number street) 5 cQ lc-,6 CI . VI v �S`i— 3 City,State,and ZIP Code City,State,and ZI Country Country 4/ 4.US _ 7T0 , Email Address certain deductions.Identify all of those that apply: , YES NO CONDITION YE NO CONDITION ›( 1.Will this property be the buyer's primary 0 3. Homestead residence? 0 ® 4.Solar Energy Heating or Cooling System 2.Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device , for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device Address(number and street) 0 ® 7. Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County ZG,`q�1 s—,3 _Qoo ,e, 3—0 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 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