Homestead_Lamey (32) H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbigail Jarvis Escrow Officer
Company
Address (number and street, city, state. country. and ZIP code)
605 SE Martin Luther King Jr Boulevard Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as it appears con eyance document
Deborah K. Borchelt
Address (number and street) Address (number and street)
12728 S Scottsdale Dr
City. State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639 C-, '44)
Country Country 1,
United States of America ' 4,s.
Email Address
, . .
certify this Sales Disclosure, to the best of myknowledge and belief, is true . • complete as required
Under penalties of perjury, I hereby c fy g . .
by law, and is prepared in accordance with IC 6-1 .1-5.5. A person who knowingly and intentionally falsifies the value 6 10 r ed real property, or
omits or falsifies any information required to be provided, commits a Level 5 felony. 06)
S* of, Seller `--- t b Signature of Seller
Printed ame of Seller Date Signed (mm/dd/yyyy) Printed Name of Seller 4 Date Signed (mm/dd/yyyy)
Deborah K. Borchelt 12/1/2025
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 co eyance document
CoryLamey A. N Zgan N. Lamey ,,v.
Address (number and street) Address (number and street)
11904 S 200 E 11904 S 200 E
City. State and ZIP Code City, State and ZIP Code '
Haubstadt, IN 47639 Haubstadt, IN 47639
• Country Country
United States of America United States of America
0
c- Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all those that apply:
• YE NO CONDITION YES/ NO CONDITION 0. ‘e,,
O ( ❑ 1. Will this property be the buyer's primary residence? N El 3. Homestead RP
p p Y Y ?r
2. Does the buyer have a homestead to be vacated for this
0 Z 4. Solar Energy Heath g or Cooling System pp
'i C°/ residence? If yes, provide address 0 a 5. Wind Power DevicA
0 El 6. Hydroelectric Power Device
M Address (number and street)
r - I 0ll 0 E ❑ p 7. Geothermal Energy Heating or Cooling Device
O City State. and ZIP Code County �� o� Z�� za i t.i - QO d D1 . 'QI 6 - 02__ .1
c4 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
t required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentionally falsMes the value of transferred real
property, or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note: Both spouse's information, SSN/Driver's
' " License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
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