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Homestead_Ziliak
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 Paul E. Doane Linda L. Doane Address (number and street) Address (number and street) 801 Iroquois Dr. 801 Iroquois Dr. City, State and ZIP Code City, State and ZIP Code Ft. Branch, IN 47648 Ft. Branch, IN 47648 Country Country United States of America United States of America Email Address 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. �iignature of SellerRjecOignaturt of Sell;r Q�JCi Printed Name of Seller Date Signed (mm/dd/ Printed Name of Seller Date Signed (mm/dd/yyyy) Paul E. Doane YYYY) Linda L. Doane 9/4/2024 9/4/2024 J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT •PPLY Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on con -.are cu nt Andrew D. Ziliak Kendall S.Ziliak 1 J/� i a Address (number and street) Address (number and street) 5156 E SR 168 5156 E SR 168 SEP I City, State and ZIP Code City, State and ZIP Code 3 1024 Fort Branch, IN 47648 Fort Branch, IN 47648 f)24-• �,/ Country t'/BSON Country COU �!� United States of America United States of America NTy At/D�p O 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: N YES NO CONDITION YES NO CONDITION U.% IZI ❑ 1. Will this property be the buyer's primary residence? RI 0 3. Homestead '''-'' S ❑ © 4. Solar Energy Heating or Coo gys�f'yn�, `'�- �.twti+r �� •6 7 N 194 ❑ 2. Does the buyer have a homestead to be vacated for 0 p 5. Wind Power Device ' this residence? If yes, provide address: 6. Hydroelectric Power Device r`f', g ❑ 0 y p Address(number and street p /�'' ( � �) 163 � � 0 RI 7. Geothermal Energy Heating or Cooling Device City, State, ZIP Code en County // // , II a-- FOr� Branch/ �7��2 &/12,5Dl elp--r9�/S-10I-000,1i4-- ar 0 Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true, correct,and complete ..Q 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 (�I transferred real property, or omits or falsifies any information required to be provided,commits a Level 5 felony. (Note:Both spouse's information, SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.) �