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Homestead_Wilson (2) H. PREPARER Preparer of the Sales Disclosure Form Title Haley Smith 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 co ey document ' Levi Jhay Dorris Address andAddress(number and street) ���QQQ 40) City,` Csttaak;and ZIP Code City,state,and ZIP Code Sep /, v�� n , Cay73 zo Country Country ?�r US US C/eS the best of my knowledge and belief,is tr I ' t and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifie a value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. Signature 9f Seller Signature of Seller Vefa Printed Name of Date signed(mm/ddyyyy) Printed Name of Seller Date signed(mm/dd/yyyy) Levi Jhay Dorris 9/10/2024 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 James Wilson Address(number and street) Address(number and street) 2410 Copper Ln City,state,and ZIP Code City,state,and ZIP Code Mount Vernon, IN 47620 Country Country US US apply for certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION 1.Will this property be the buyer's primary O O 3. Homestead residence? O O 4. Solar Energy Heating or Cooling System 2. Does the buyer have a homestead to be vacated O O 5.Wind Power Device 41- O for this residence? If yes, provide address: O O 6. Hydroelectric Power Device Address(number and street)p Q Q 7. Geothermal Energy Heating or Cooling Device �l code,anti douu ty City,state, (moo' 1 8 ^Io - 0l7 -© Z - 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 r r '' 0 ,�T' 47