Homestead_Flowers H. PREPARER
Preparer of the Sales Disclosure Form Title
Payge Marx Escrow Officer
Company
Address(number and street,city,state,country,and ZiP Code)
7412 Eagle Crest Blvd 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
John R.Langworthy Nancy A. Langworthy
Address4:a(number and street) c� Addrgss4-V- (number� and street)t n P octcf
Ci ,stateV,andZIPrYti`-n- V A .1% 1 I City,` i'11�Th 1-1)1 1'C- & A I 1 1
Country Country
US US
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who k ingiy Int tionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided,co its a L 5 f ony.
Signature S er SI re of ,��
r' t of r Date signed(mm/dd/yyyy) ri am of Seller Dat m/dd )
n R. La gworthy "4•27‘0.5t2t21-124-ii Nan . Langworthy �r -12105/2023 12I i7.0 J
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PRO,g RTY TAX DEDUCTIONS-IDE FY L AT PPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conve d en
Travis A.Flowers
Add res (numb and street) Address(number and street) U`'C
103 . . COI)i',A S 0� �Z
:! i
Country UNrY -
US US -10
certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary O O 3.Homestead
O O resi ce? 0 O 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
O for this residence?If yes,provide address: p l 6.Hydroelectric Power Device
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
QLD-1 - 4 - 10. - Can. O - nO
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
4, .` r,.
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