Homestead_Lee (2) H. PREPARER
Preparer of the Sales Disclosure Fo fln
Title
r_(.G'UfwA /�� / Title Company
Company
Address(number and street,city,state,country,and ZIP Code) Iti,t
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I. SELLER S /GRANTORS
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appea conveyance dibt
David E.Osborne Justine M.Osborne �CC 1 n
Address(number and street) Address(numbe d street) J ‘01a
7908 S 100 E 7908 S 100 I ;/e
City,State,and ZIP Code City,State,and Zlqq 6t Q
Washington,IN 47501 •
Washington,IN 47501 0UN7), c,
Country Country 441O/TOR
US US
( ) & ,
Under penalties of perjury,I hereby certify 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 transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Sig 'r) of Seller S. aturee of Seller
Printed Name of Seller Date Signed(mm/dd/yyyy) r ted Name of Seller Date Signed(mm/dd/yyyy)
David E.Osborne 12/15/2023 Justine M.Osborne 12/15/2023
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
Little J.Lee Sandra R.Lee
Address(number and street) Address(number and street)
4801 Rolling Ridge Dr 4801 Rolling Ridge Dr
City,State,and ZIP Code City,State,and ZIP Code
Evansville,IN 47712 Evansville, IN 47712
Country Country
US
YES NO CONDITION Y S NO CONDITION
Nia O 1.Will this property be the buyer's primary 0 3. Homestead
residence? 0 ® 4.Solar Energy Heating or Cooling System
` p.. 2. Does the buyer have a homestead to be vacated 0 (X 5.Wind Power Device
O "1- for this residence? If yes, provide address:
0 ® 6.Hydroelectric Power Device
Address(number and street) O ® 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County 26-1 Z , 0 6- 7,01.4 -o O L) • )2r; - O 2 e
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