Homestead_Evans (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Jamie E. Smith Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715
I.SELLER(S)/GRANTOR(S) ' T
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on cooar e-cum D
RANDALL D.OWEN 11 11
Address(number and street) Address(number and street)
508 E Montgomery Street FEB 2�23
City,state,and ZIP Code - City,state,and ZIP Code
Owensville, IN 47665
Country Country �y,
/ /LCGft.„,_c a.
fic - •
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.
ign o ell �rPrinted
of Seller
Name of Se Il er Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
RANDALL D.OWEN January 26, 2023 January 26,2023
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
AJ EVANS
Address(number and street) Address(number and street)
508 E Montgomery Street
City,state,and ZIP Code City,state,and ZIP Code
Owensville, IN 47665
Country Country
NO CONDITION
Lr1L-�If/ 1.Will this property be the buyer's primary r�fil 1:2,- 3.Homestead
❑ fesidence? 0 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 J 5.Wind Power Device
for this residence? If yes,provide address: ❑ 6.Hydroelectric Power Device
Address(number and street) ❑ �7.Geothermal Energy Heating or Cooling Device
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