Homestead_Lichte H. PREPARER
.
Preparer of the Sales Disclosure Form Title
Payge Marx Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I.SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Paul Gene Willis,Jr.
Add/Bss(number and street) J ` �� Address(number and street) 1...:
0j'p_ ,and ll..d {_JI U/V{,� X- f
•
City,s ZlP T �' 5y y��' City,state,and ZIP Code
3 -4: x. ,
Country Country
US US °qp�y<-"
E-mail 7 ,,
e V !
my knowledge and belief, uno�oorrect and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally. 'fiq evalue of transferred
r =I,property,or omits or falsifies any nformation required to be provided,commits a Level 5 felony. 'Y
S_natur Seller j• ( Signature of Seller 'iC/QT h
r f �L ` / t3� v l
'tinted N me of Seller "��ll�� Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/ lyyyy)
Paul Gene Willis, Jr. 04/14/2023
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
Mark G. Lichte
Address(number and street) Address(number and street)
315 N Gibson St
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670
Country Country
US US
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 0 3. Homestead ilk i'
0 0
re ` ence. 0 2 4.Solar Energy Heating or Cool Alai ii4,
9 �•
2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device is, f
0 for this residence? If yes,provide address: 0 0 6.Hydroelectric Power Device , }
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county ac- 12-01-- l,t o I 0 0 (41 y -022 •
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
Last 5 of SSN:
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