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Homestead_Sheraden 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 conveyance document Estate of Georgia C. Dillon Address(number and street) Address (number and street) 309 Hawthorne Drive �f���fff City, State and ZIP Code City, State and ZIP Code ,Q0� Princeton, IN 47670 ' O�C ����JJJJ Ununtry ited to States of America Country G/�eISOii/C �' ZUZI Email Address 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 mits r falsifies any information required to be provided,commits a Level 5 felony. .4..S.40,1 orS I Signature of Seller Pri 0 Name of Seller Date Si ned (mm/dd/ Printed Name of Seller Date Signed (mm/dd/yyyy) Da id Garrison, Personal Representative , vvvv) 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 Doyce Sheraden Ruth Sheraden Address(number and street) Address (number and street) VLIS 9 214 5th Street 214 5th Street " ,_,:^' City, State and ZIP Code City, State and ZIP Code 0 ''' io Carmi, IL 62821 Carmi, IL 62821 4 Country Country United States of America United States of America Email Address YES NO CONDITION YES NO CONDITION El ❑ 1. Will this property be the buyer's primary residence? 0 0 3. Homestead ❑ El 4. Solar Energy Heating or Cooling System 0 © 2. Does the buyer have a homestead to be vacated for ❑ El 5. Wind Power Device this residence? If yes, provide address: ❑ El 6. Hydroelectric Power Device Address (number and street) 0 0 7. Geothermal Energy Heating or Cooling Device City, State, and ZIP Code County • 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