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Homestead_Blanton (3)
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 cony ocument Daniel Richardson Address(number and street) Address(number and street) '4,4 3259 E State Road 56 ,✓1(;, City, State and ZIP Code City,State and ZIP Code f 4?: Hazleton, IN 47640 ' � I q7, Country Country 0 _ 4,States of America Email Address Address OOC Q Telephone Number • Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,correct,an omplete as required by law,and is prepar 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 an i ationr"required to be provided,commits a Level 5 felony. ignature of Selle_ ' J Signature of Seller Printed Name of Se er Date Signed(mm/dd/ Printed Name of Seller Date Signed(mm/dd/yyyy) Daniel Richardson YYYY) 12/3/2024 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 Jake Blanton Nicole Marie Blanton Address(number and street) Address(number and street) 5600 State Road 68 5600 State Road 68 City, State and ZIP Code City,State and ZIP Code Lynnville, IN 47619 Lynnville, IN 47619 Country Country United States of America United States of America Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.identify all of those th .apply: YES NO CONDITION YES NO CONDITION r 0 ❑ 1. Will this property be the buyer's primary residence? RI 3. Homestead 4dr ..; ❑ I1 2. Does the buyer have a homestead to be vacated for ❑ RI 4. Solar Energy Heating or Coolin '- '-' this residence? If yes, provide address: 0 © 5. Wind Power Device Address(number and street) 0 © 6. Hydroelectric Power Device 0 El 7. Geothermal Energy Heating or Cooling Device City, State, and ZIP Code County r O '.- S-4, - b94- oo.1 .6oa- OR' . 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