Homestead_Toone ,
H. PREPARER
Preparer of the Sales Dis osure Form Title
(' _._ _ .._ kJ Title Comipany
Company LLLL{{{{JJJI
Address(number and street,city,state. country,and ZIP Code)
7820 Eagle Crest Blvd.Suite 201,Evansville, IN 47715
I. SELLER(S)/G_R_ANTOR(S) __ ____
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Daniel J.Lefler FILED
Address(number and street) Address(number and street)
6771 S 550 E
City,state,and ZIP Code City.state,and ZIP Code MAY 0 5 2022
Fort Branch,IN 47648
Country Country
tom( a.
US r�;Apt1D%TOR
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.
SiflnatureQ/!oj/JSeller Signature of Seller
Printed t'anie of� � Date signed(mrn/dd/yyyy) Printed Name of Seller Date signed(mmfdd/yyyy)
Daniel J.Lefler 04/29/2022 _J 04/29/2022 ___,
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
Nathan Samuel Toone
Address(number and street) Address(number and street)
10033 Brook Meadow Drive _
City,state.and ZIP Code . City.state,and ZIP Code
Evansville,IN 47711
Country Country
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 ® 0 3.Homestead
p 0 residence? 0 Ok 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 M 5.Wind Power Device
0 for this residence?if yes,provide address: p I 6.Hydroelectric Power Device
Address number and street) - _ - 0 (2i 7.Geothermal Energy Heating or Cooling Device
City,slate.ZIP code,and county A-N-1 >-1-100_000, 6 3 --Q 2__Y
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
copy