Homestead_Waites H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
Company
Address (number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on conveyance document
Logan Dilbeck
Address (number and street) Address (number and street)
308 S. Mill St.
City, State and ZIP Code City, State and ZIP Code
owensville, IN 47665
Country Country
United States of America
Email Address
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.
xSignatur of Seller,/4,( Signature of Seller
Printed Na a of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
Logan Dilbeck 1/8/2024
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Randel S. W. Waites Stacey Waites FILED
Address (number and street) Address (number and street)
808 S. Hall St. 808 S. Hall St.
City, State and ZIP Code City, State and ZIP Code JAN 1 2
Princeton, IN 47670 Princeton, IN 47670 2024
Country Country L
United States of America United States of America %��2 (� . ;
Email Address
used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
E ❑ 1. Will this property be the buyer's primary residence? 7 0 3. Homestead
❑ El 4. Solar Energy Heating or Cooling System
❑ 2. Does the buyer have a homestead to be vacated for 0 p 5. Wind Power Device
this residence? If yes, provide address:
❑ 0 6. Hydroelectric Power Device
Address(number and street) ❑ 71 7. Geothermal Energy Heating or Cooling Device
808 S. Hall St.
City, State,ZIP code, and county �'
Princeton, IN 47670 Gibson c l�I 7-/D.-cO 3 •
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
transferred real property,or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note:Both spouse's
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