Homestead_DeShields 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
Lee McCray
Address(number and street) Address(number and street)
� Z3 c16itc St.
Ci state,and ZIP Code City,state,and ZIP Code
Fri nc-e rule 10
Country Country
US US
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.
Si,gnature of Iler n Signature of Seller
t�� /
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Lee McCray 09/27/2023
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDE IFY L HA PLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveya en
Michael DeShields .Sc
Address(number and street) Address(number and treet) C p 2
6600 Romaine Road 20Z3
City,state,and ZIP Code City,state,and ZIPS
Poseyville, IN 47633 p 1
ON
Country Country q
US US UNTyhaJ
Off)
YES NO CONDITION
O O 1.Will this property be the buyer's primary O 0 3. Homestead
residence? 0 O 4. Solar Energy Heating or Cooling System
O 2. Does the buyer have a homestead to be vacated 0 O 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
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