Homestead_Williby 5/6/t)
H. PREPARER
Preparer of the Sales /Disclosure; o Title
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Title Company
Company
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Justin H.Kohlmeyer
Address(number and street) Address(number and street)
.3 8S LA! c)1.. . �l„✓ce7z„l k 1P. P t
City,State,and ZIP Code City,State,and ZIP Code I-C .tt -
C7u/eti.1 4 II<- ( --/A) 44-?“5 A,Qp
Country Country rf /
US ?O
of my knowledge and belief,Wilt . t,and com lete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally fa sift, ' e f transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. /i. _ \
Signature of Seller Signature of Seller )
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rinte ame of Selle Da of ne dd/ Pin
��� YYYY) Printed Name of Seller Date Sign d(mmldd/y )
Justin H.Kohlmeyer 02/28/2024
J. BUYER(S)IGRANTEE(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
Steven L.Williby Shari L.Williby
Address(number and street) Address(number and street)
5960 Avienda Barcelona 5960 Avienda Barcelona
City,State,and ZIP Code City,State,and ZIP Code
Yorba Linda,CA 92887 Yorba Linda,CA 92887
Country Country
US
YES NO CONDITION YES NO CONDITION
0 1.Will this property be the buyer's primary IX 0 3. Homestead
residence? 0 0 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated G ® 5.Wind Power Device
I ® for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
2C —A2-Zg-400 _ not . 33s--02,
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