Homestead_Whitman H. PREPARER
Preparer of the Sales Disclosure Form Title
Christina Gourley Title Clerk
Company
Address(number and street,city,state,country,and ZIP Code)
4600 Washington Ave, Suite 102, Evansville, IN 47714
I. SELLER(S)/GRANTOR(S)
WO-1(1(W AINf1OD NOSe13
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on c4
Estate of Leigh A Davis rt� "- ` �3��
Address(number and street) Address(number and street)
1\3� N .'tkAck ,� S1< - Z OZ 0 C 9nd c__)
city,state,and ZIP Code ,i �t City,state,and ZIP Code
.(VI e .A t 1J 1 ke-1,0 j T
Country LLS , Country G H I d
E-mail address
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.
Signature of Seller ' Signature of Seller
Printed Name of eI Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Christopher Davis,Personal Representative a J a p v 2
I
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
Brandi Whitman
Address(number and street) Address(number and street)
9 .."1 N YY)Ct l Y\
ity,_state,and ZIP Code City,state,and ZIP Code
YID c m-\ \ U1iii 0
Country U \ Country
E-mail address /
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YE NO CONDITION
O 1.Will this property be the buyer's primary O 3. Homestead
residence?
0 O 4.Solar Energy Heating or Cooling System
O 2.Does the buyer have a homestead to be vacated O C) 5.Wind Power Device
for this residence? If yes,provide address: 0 O 6. Hydroelectric Power Device
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
A' 12-- o 6--3 - ool - 3o-1- o2-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
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