Homestead_Wilhite H. PREPARER
Preparer of the Sales Disclosure Form Title
Leah Brown
Settlement Agent
Company
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on convey q
LarryT.Osborn Ethel L.Osbom
Address(number and street) Address(number and street) NO V
7324 N Frog Pond Road 7324 N Frog Pond Road
City,Stale,and ZIP Code City,State,and ZIP Code �a�7
CoHazleton,IN 47640 Hazleton,IN 47640 1
try Country G/SSON C' }
us Us
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best of my knowledge and belief,Is true,correct,and complete as
required by law,and Is prepared In accordance with IC 6-t.1-5.5.A person who knowingly end Intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
• S_✓ of Seller
� f;; �'- Signature of Seller
rinted1>Isitie or Seller Date Signed(mm/dd/yyyy) Printed Name of Seller` Data Signed(mm/dd/yyyy)
Larry T.Osborn 11/05/2024 Ethel L,Osborn 11/05/2024 ______. p
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
Jason Wilhite Tla Wilhite
Address(number and street) Address(number and street)
t' 7665W2755 7685W2755
I City,Stale,and ZIP Code City.State,and ZIP Code
Owensville,IN 47665 _ Owensvllle,IN 47665
Country _ Country
YES NO CONDITION
® O 1.Will this property be the buyer's primary al 0 3.Homestead
residence? p ►:+ 4.Solar Energy Heating or Cooling System
0
® 2.Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
for this residence?If yes,provide address: 0 Dil 6.Hydroelectric Power Device
Address(number and street) 0 ( 7.Geothermal Energy Heating or Cooling Device
City,State,end ZIP Code County 26 -p s--_ q---..-0 7 Z_ Oen .4-s-3 4- •
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Fs 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
Al
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