Homestead_Anderson (10) H. PREPARER
Preparer of the Sales Disclosure Form Title
Kayla Vaughn Closing Agent
Company I
Address(number and street,city,state,country,and ZIP Code)
17 W. Main Street, Poseyville, IN 47633
I. SELLER(S)IGRANTOR(S)
1 Seller 1 —Name as it appears on conveyance doc ent Seller 2—Name as appears on conveyance document
Gregory L. Davis. Co-Exec Kenneth Davis Est anna D. Reynolds,Co-Exec Kenneth Davis Est
9 rY y s.
Address(number and street) \ dress(number and street)
634 Reis Ave JUN 3700 E 600 S
City,State,and ZIP Code D24 City,State, and ZIP Code
Evansville, IN 47711 �� . Ft. Branch, IN 47648
Country G/eS Count
ON OOUN ry
Email Address
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.
Signature of Seller '-S4'gg aa\tuAreRof_S`ell_e'r^ p\\ya
. 0 .0-4._.71r...E} ja--
Printed Narnecteliej Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy)
Gregory L. Davis. Co-Exec Kenneth Dt 06/11/2024 Deanna D. Reynolds, Co-Exec Kennett 06/11/2024
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
IBuyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
I Andrew Lee Anderson Jamie Lynn Anderson
Address(number and street) Address(number and street)
204 N 3rd St 204 N 3rd St
City,State,and ZIP Code City,State, and ZIP Code
I Owensville, IN 47665 Owensville, IN 47665
CJ Country Country
0 __
( Email Address
- YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead
O residence? ,,
❑ ❑ 4. Solar Energy Heating or Cooling System
s ' rx 2. Does the buyer have a homestead to be vacated ❑ ❑✓ 5.Wind Power Device
p ❑ for this residence?If yes,provide address: ❑ 0 6. Hydroelectric Power Device
-5 Address(number and street) ❑ ❑✓ 7.Geothermal Energy Heating or Cooling Device
i 204 N Third St
r
O,State,and ZIP Co
wensville,de IN 47665 Gibson Cou 2c"17_ 30"�U _ co - . 3 ' .1 - O 2(
l` 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