Homestead_Donnell (2) H. PREPARER
Preparer of the Sales Disclosure Form Title I
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)IGRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
TAMARA S. DODGE
Address(number and street) Address(number and street)
303 S Hart Street
City,State,and ZIP Code City,State,and ZIP Code
Princeton, IN 47670-2127
Country Country
E-mail Address
Level 5 felony.
i• ure of Seller Signature of Seller
•nnted Name of Se ler Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
TAMARA S DODGE January 24,2024 January 24, 2024
J. BUYER(S)IGRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THA PPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance d,�t
PATRICK J. DONNELL SHELBY M. DONNELL
.4.46/:).
Address(number and street) Address(number and street)
303 S Hart Street 303 S Hart Street
City,State.and ZIP Code City,State,and ZIP Code
Princeton, IN 47670-2127 Princeton, IN 47670-2127 qR f'�
Country Country 4
G/6,
E-mail Address
NO CONDITION 'JR (((
1.Will this property be the buyer's primary 3.Homestead
❑ re idence?
❑ 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 5.Wind Power Device
❑ for this residence?If yes,provide address: 0 21 6.Hydroelectric Power Device
Address(number and street) ❑ 112( 7.Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County
) Z 01 - 302-130k-1 . 6d1 — 02g .
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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