Homestead_Oelheim 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)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears onveyance document
OLIVIA BIRDWELL
Address(number and street) Address(number and stree)
5165 S Bannerstone Drive
City,State,and ZIP Code City,State,and ZIP Code4/.) `
•
Owensville, IN 47665-8712 uV ,
Country Country 4 2423 C A
0/et., v\
best of my knowledge and be id!(y),/„ correct and complete as I
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally f ifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Sig ure f Seller Signature of Seller
Prin ed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
OLIVIA BIRDWELL July 14, 2023 July 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
DENNIS OELHEIM JR. MAKENZIE OELHEIM
Address(number and street) Address(number and street)
5165 S Bannerstone Drive 5165 S Bannerstone Drive --
City,State,and ZIP Code City,State,and ZIP Code
Owensville, IN 47665-8712 Owensville, IN 47665-8712
Country Country
'
YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary CK 0 3.Homestead
residence? 0 Iy 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated ❑ [ 5.Wind Power Device
El 2.
this residence? If yes, provide address: ❑ la 6.Hydroelectric Power Device
Address(number and street) 0 El. 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