Homestead_Hill (3) 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. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Lloyd Jones
Address(number and street) Address(number and street)
City,state,and ZIP Code City,state,and ZIP Code
Country Country
US US
E-mail address Telephone number E-mail address Telephone number
( ) ( )
Under penalties of perjury,I hereby certify 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 transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signature of Seller Signature of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller , Date ••ned(mm/dd/yyyy)
Lloyd Jones 12/07/2023
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTION IDEN4I))9tZ'A)`L THA • j
Buyer 1-Name as it appears on conveyance document Buyer 2-Name asat a s on conveyyadcegocumen
Chandler J. Hill Nicole O. Hill `904,4 e. W3
Address(number and street) Address(number and streetf'OI.CT
724 Fairway Drive 724 Fairway Drive
City,state,and ZIP Code City,state,and ZIP Code 100/
Evansville, IN 47710 Evansville, IN 47710 OR
Country Country
US US
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary O 0 3. Homestead
O residence? 0 l J 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: O I] 6. Hydroelectric Power Device
Address(number and street) 0 Q 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
LV--1 k-\S- ►Qt - 0b0 - 007
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
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