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Homestead_DeLong (6) H. PREPARER
Preparer of the Sales Disclosure Form Title
Milton Norman Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
25 NW Riverside Drive,Suite 310, Evansville,IN 47708
I. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance rent
George L.Lanham,IV April A. Lanham 4P
1.)
Address(number and street) Address(number and street)801
801 Tretter Park Dr 801 Tretter Park Dr 6
City,State,and ZIP Code City,State,and ZIP Codee/eSo ��jy
cr------• '
Fort Branch, IN 47648 Fort Branch, IN 47648 tiC,O Q
Country Country vti�
US US ,40 . . c.. \/_)
Email Address
( )
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 I .prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
real property, or falsifies any information required to be provided,c mits a Level 5 felony.
Signature of e J Sign 9f Seller ,, �o(i1 r �1 tt
r /J
x.,„Ja.t,_-‘
Printecj4 ,4f Seller Date Signed(mm/dd/yyyy) Printed rme of Seller Date Signed mrn/dd/yyyy)
Georef.Lanham, IV C}Ll /j pU_9(/ April A. Lanham O ) 19-- c () i
J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APP Y
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Seth Owen DeLonq
Address(number and street) Address(number and street)
500 East Sinclair St
City,State,and ZIP Code City,State,and ZIP Code
Fort Branch, IN 47648
Country Country
US
Email Address
( )
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
DO1.Will this property be the buyer's primary ( 0 3. Homestead
residence? 0 ® 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 M 5.Wind Power Device
for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device
Address(number and street) 0 (i 7. Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County •
46_ 1-1_ 1q —3OL_ Ot.) ,�0 . 6LIq- -O /
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct,and complete
.
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