Homestead_Young 1. PREPARER '
'reparer of the Sales Disclosure Form Title
Matthew Janis Escrow Cffcer
company ;
4ddress (number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Bcu.evard, Evansville IN United States of America 477'3
. SELLER(S)/GRANTOR(S)
Seiler 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyance document
Estate of James David Willis, deceased
4ddress (number and street) Address (number and street)
318 N. Pc k St.
amity. State and ZIP Code C'ty, State and Z - Code
Dakiand City, iN 47660
Jcuntry Country
Jnited States of America
Email Address
i
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.
S. a'ure af,S SignatLre c`Se er
` t ink i) Sv a-- t/Printed Name of Seller Date s gned ;-riir-idd:yyyy) Printed Name of Seiler f Date signed ;.rTriddiyyyy;
Patricia Briere, Personal Repress X Nis/2-07-3 i
J. BUYER(S)/GRANTEE(S)-A0PLICATCN FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1 -Name as it appears cr, conveyance document j Buyer 2-Name as It apptu is nveye ent
Vickie Elizabeth Young LL
Adoress!number and street) Address (-umber and street)
102 N Forrest St I DEC 19 2023
City, State and ZIP Code City, State and ZIP Code
County Co ' tr y GIBSON COUNTY AUDITOR
United Slates of America
'Email Address _
- :
apply for certa deductions. Icier'' a I of those that apo ,'.
YES ':O CC':C''.DN cS ND CDR:=:'.C"J
RI C 1, 'dJ l t hiS pr:TE77: Le`'}e buyer's primary residence? 7 - 3. Homestead
O Z 4. Soar Energy Heat:rig or Cooling System
C C 2. Coes the buyer ne;e a ^:.omestead to be vacated for C C 5. Wind Power Device
this residence? f yes, provide address:
C 71 6, Hydroelectric Power Dev•ce
Address(number and street) 0 C 7 Geothermal Energy `seating or Cooling Device
City, :tale,ZIP code, and county G 1
y-t -- 2.4o3- oo(.- cis - dos
Under penalties of perjury,I hereby certify that this Sa:as Disclosure,to the best of my knowledge and belief, Is true, correct and complete
as required by law,and is prepared in accordance with 1C 6-1,1-5.5.A person who knowingly and intent'onaly falsifies the value of