Homestead_Greenwell H. PREPARER
Preparer of the S es isclos_ure Form ],, / Title
/4 �ltll/ Title Company
Company
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on cony an d ment
Patrick Shawn Donnell Address(number and street) Address(number and street) 4 ��
209 Zimmerman Drive a ,r
City,State,and ZIP Code City,State,and ZIP Cod=- /6?
Princeton,IN 47670 C,/ 6?y
Country Country ITO*"
US CO i j?) /
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.
Sign.lture of Seller Signature of Seller
iliZtk1L /
Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Patrick Shawn Donnell 04/15/2024 04/15/2024
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
Lenae Greenwell Beau Greenwell
Address(number and street) Address(number and street)
996 S 250 W 996 S 250 W
City,State,and ZIP Code City,State,and ZIP Code
Princeton,IN 47670 Princeton, IN 47670
Country Country
rt. US US
tJ
l
rsuant 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
r 0 1.Will this property be the buyer's primary O 3. Homestead
3". residence? O ® 4. Solar Energy Heating or Cooling System
fl O 2. Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device
0
0 AC �mb�and e�}.. �_ 0 (27.Geothermal Energy Heating or Cooling Device
City late,and ZIP Copde `�'� County
.7.
a IS, 1t3471C - 1-6 2` ^tZ-o6— 03- 000. l8N— 01e
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct,and complete
t 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
V transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
rdinfonna 'on,SSN/Driver's License/ID/Other Number is necessary only if a Homestead Deduction is being filed.)
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