Homestead_Kenworthy i H. PREPARER -- - _ .. • - --- _ .� . __
Preparer of the Sales Disclosure Form Title
Leah Brown Closing Agent i
Company
Address (number and street, city, state, country, and ZIP Code)
7820 Eagle Crest Blvd, Suite 201. Evansville, IN 47715
JS) 9 )
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on nce document
Debora A. Blackburn
Address (number and street) Address (number and street)
302 Harding Avenue 4//,,
City, State, and ZIP Code City, State, and ZIP Code V,�j <2 ii
Princeton, IN 47670 _- J �°
Country Country wash ��
U Scit `-'
the best of my knowledge and belie , orrect, and complete as
Lrequired by law, and is prepared In accordance with IC 6-1.1-5.5. A person who knowingly and intentionally ifies the value of transferred
real property, or omits or falsifies any Information required to be provided, commits a Level 5 felony.
gr5at re pf Seller Signature of Seller '
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Printed Name of Seller Date Signed (mm/dd/yyyy) Printed Name of Seller Date Signed (mmfdd/yyyy)
Debora A. Blackburn 08/26/2025 I 08/26/2025
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL THAT APPLY
uyer 1 - Name as it appears on conveyance document Buyer 2 - Name as it appears on conveyance document
Re cca J. Kenworthy Jalen A. Kenworthy
I Addre (number and street) Address (number and street)
1007 S IRace Street 1007 S Race Street
L.
City, State, and ZIP Code City, State, and ZIP Code
Princeton, IN 4767,Q Princeton, IN 47670
Country X, Country
US US
. - - :- —
I YES NO CONDITION YES NO CONDITION '
r 1. Will this property be the buyer's primary V ❑ 3. Homestead
la residence?..-
O ® 4. Solar Energy Heating or Cooling System
rr--)O ® 2. Does the buyer have a homestead to be vacated 0 ® 5. Wind Power Device
Lfor this residence? If yes, provide address: ❑ 2 6. Hydroelectric Power Device
Address (number and street) 0 ® 7. Geothermal Energy Heating or Cooling Device
1
City, State, and ZIP Code County 1 (9 1 Q Z
009+,,
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YES NO CONDITION 3. Planned use of the property?
(,--2 X 1. Changes to the property between Jan. 1 and sale date? Describe: Rebecca is a non-occupying title holds
Describe: _ Jalen will be living on the property as a primary
O ® 2. Property is a residential rental property. ! residence.
E. FINANCE DATA - Complete only those that apply.
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