Homestead_Workman 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
James D. Pollitt Barbara A. Pollitt
Add nu�rber d st t)l/a n j Ad ,iurr
L/11 � 11U
.6; -..CS-
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City, faeP� I ntry ) � Count ��1Yti�vVl
Country
US US
Under penalties of perjury,I hereby certify this Sa es Disclosure, o the best of my knowledge and belief,is true,correctdcomplete 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,corn , a Level 5 felony.
• natur Seller Signat Sel-r
0 /-aleee, Iry 4 . ---------
rinted Name of Seller Date signed(mm/dd/yyyy) - -: Name of Seller Date signed(mm/dd/yyyy)
James D. Pollitt 12/29/2023 Barbara A. Pollitt 12/ •/2023
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY H it •PLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appe co veya . ent
Lane P. Workman Misty D. Workman
Address(number and street) Address(number and stree O'l(�
421 South 4th Street 421 South 4th Street (\61 (-C
City,state,and ZIP Code City,state,and ZIP Code JPN
•
Princeton, IN 47670 Princeton, IN 47670 nn� vQ`�OF
Country Country ��� (b'�.( P
US US ��}'" N"OVN
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
O 0 1.Will this property be the buyer's primary D O 3. Homestead
residence? 0 O 4. Solar Energy Heating or Cooling System
O ( .02. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence? If yes, provide address: O p 6. Hydroelectric Power Device
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
(X0- i a- iat-300 T MI . IQl► '-'0 a--7
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
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