Homestead_Lamey H. PREPARER
Preparer of the Sales Disclosure Form Title
Haley Smith 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
Wanda M. Thompson
Address(number and street) � I Addres (number and street)
a000 (. J • Vr•:�..,..Jb !7 . 1 a S 5 t,
City, and ZIP odeG City,state,and ZIP Code
11C1 c C(4�/ Az t-trgeliO
Country / Country
US US
E-mail address A
knowingly and intentionally falsifies the value of transferred
r al property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
nature Iler,95)„,
Signature of Seller
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P n ed Name of Seller Date sign d(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Wanda M. Thompson 1/5/2024 22
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS l A HAT APPLY
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it app ar Huey d u nt
Blair A. Lamey Madison J. Lamey
Address(number and street) Address(number and streejA Al
80 West 800 South Apt 5201 80 West 800 South Apt 521V 8 ?g
City,state,and ZIP Code City,state,and ode
Fort Branch, IN 47648 Fort Branch,N
Country Country CO(/NT,
US US y AUD/Tp
YES NO CONDITION YES NO CONDITION
O O 1.Will this property be the buyer's primary O O 3. Homestead
residence? O O 4. Solar Energy Heating or Cooling System
O V2. 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 Q 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
al2-t3-a0—aO0—coo-014y-Cek-A
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
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