HomeMy WebLinkAboutHomestead_Dillon 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
1. SELLER(S)IGRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as it appears on conveyance document
Florent Saliju by Zenel Saliju, attorney-in-fact Arjeta Saliju by Zenel Saliju, attorney?,
Address (number and street) Address (number and street)
203 S Willard Sti ED
203 S Willard St
City, State and ZIP Code City, State and ZIP Code
Fort Branch, IN 47648 Fort Branch, IN 47648 DEC 2 2 2025
Country #
Country
United States of America
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.
Signature of Seller '7 ' / Signature of Seller I
At
Y 71 � . 3, L fj' h w -, _ -, , X n'17 i l` /4 c i ., / , 4 2�---_-
Printed Name of Seller // 7 Date Signed (mm/dd/ Printed Name of S r
Date Signed (mmlddlyyyy)
Florent Saliju by Zenel Saliju, attorney-in- YYYY) Arjeta Saliju by Zenel Saliju, a -fact 12/18/2025
fact 12/18/2025
J. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL THAT APPLYE a
Buyer 1 - Name as it appears on conveyance document Buyer 2 - Name as it appears on conveyance • • . ent
Bailey Dillon Heather Dillon L?EC
� f. ? t)
Address (number and street) Address (number and street) , -G25
927 N Hart St 927 N Hart St ..._-__..J-
City, State and ZIP Code City, State and ZIP Cd �LC
Princeton, IN 47670 Princeton, IN 47670 O� COv� •l�
Country Country �'�VD�1
Op
United States of America United States of America
Email Address
for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
Z ❑ 1. Will this property be the buyer's primary residence? El ❑ 3. Homestead
0 2. Does the buyer have a homestead to be vacated for ❑ El 4. Solar Energy Heating or Cooling System
this residence? If yes, provide address: 0 El 5. Wind Power Device
Address (number and street) 0 El 6. Hydroelectric Power Device
927 N Hart St 0 El 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
Princeton, IN 47670 Gibson 6 -- /3-fg -- 34O 8-- coo , 4011- a .2_(o
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