HomeMy WebLinkAboutHomestead_Wilson (2)H. PREPARER i
Preparer of the Sales Disclosure Form
Title i
Jan Weldy
Settlement Agent
Company
Email Address
Telephone Number
Regional Title Services of Washington
jan.weldy@regionaltitlellc.com
( 812 ) 642-5127
i Address (number and street, city, state, country, and ZIP Code)
406 E. Flora St, Washington, IN 47501
1. ELLER(S)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
Davenport Properties, LLC
Address ((number andsli�
Address (number and street)
g !
Ci e, nd Z P Code
City, State, and ZIP Code
in
Country
Country
US
Email Address Telephone Number Email Address Telephone Number
I
yg-5 353C9_ ( )
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 j
real property, or omits or falsifies any Information required to be provided, commits a Level 5 felony.
Signature o/f Seller
Signature of Seller
Printed Name of Seller
Date Signed (mm/dd/yyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
George Davenport, Member
09/08/2026
09/08/2026
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
onveyance documentjLo
an D. Wilson�s
tr
(numb nd street)
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Address (number an
Ci S ate, and ZIP Code
City, State, and ZIP C 1_
Country
Country 1
US
Email Address
Telephone Number
Email Address lV CpVN •
�
Telephone Number
logwilson23@gmail.com
( 812 ) 890-9208
'gUDI
( )
Pursuant to IC 6-1.1-12-44, the Sates Disclosure Form may be used to apply f r certain deductions. Identify all of those that apply:
YE NO CONDITION
YE NO CONDITION
1. Will this property be the buyer's primary
O 3. Homestead
residence?
O ® 4. Solar Energy Heating or Cooling System
O ® 5. Wind Power Device
❑ ® 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
❑ ® 6. Hydroelectric Power Device
O ® 7. Geothermal Energy Heating or Cooling Device
r� �y1
�d — I F �� — CQL4q'"
Address (number and street)
City, State, and ZIP Code County
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 1
transferred real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note: Both spouse's
Information, SSN/Drhrer's LicensOD/Other Number Is necessary only if a Homestead Deduction Is being Hied.)
Signature Qf Buyer 1
1 L',J�
Signature of Buyer 2/Spouse
PrintoTt-e I Name of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Logan D. Wilson 9/8/2026
09/08/2026
Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
K
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