Homestead_Pyle (5) H. PREPARER
Preparer of the Sales Disclosure Form Title
Jan Weldy Settlement Agent
t Address (number and street, city, state, country, and ZIP Code)
412 E. Flora St, Washinton, IN 47501
I. SELLERS)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on conveyance document
Bailey Douglas Dillon
Address (number and street) Address (number and street) ,!
927 N Hart Street
City, State, and ZIP Code City, State, and ZIP Code
Princeton, IN 47670
Country Country OFC
US f
best of my knowledge ani ,9,.e0q4 true, correct, and complete as
Lrequired by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentitfr fies the value of transferred
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. ��t-4��'�` -
Signature of Seiler - Signature of Seller v&
Printed ame of Seller I Date Signed (mm/dd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy)
Y Douglas Bailey Dou Dillon 12/12/2025 12/12/2025
J. BUYER(S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL THAT APPLY
81.11 - Name as it appears on conveyance document 1Buyer 2 - Name as it appears on conveyance document
Jeffery Pyle
Address (number and street) Address (number and street)
309 W Brumfield Avenue, Apt Z
City, State, and ZIP Code City, State, and ZIP Code
Princeton, IN 47670
Country Country
US
Email Address
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 ® Li 3. Homestead
residence? 0 (X 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 ® 5. Wind Power Device
❑ 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 � � ' � ^ � �
bG 3 ( . 6CIS 02-a
Last 5 Digits of Buyer 2JSpouse SSN/Driver's License/ID/Other Number
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