HomeMy WebLinkAboutHomestead_WellenH.. PREPARER
Preparer of the Sales Disclosure Form
Title
Allyn Tresenriter
Escrow Officer
Company
Email Address
Telephone Number
Foreman Watson Land Title
ATRESENRITER@FM/-LT.CONI
(812 ) 909-4543
Address (number and street, city, slate, country, and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document
Seller 2 — Name as appe& on on ya c ent
Berne L. Flelds
Address (number and street)
Address (number and street)
gurin 01-)19,!
JUL
City, Stal ,and ZIP Code ,e I f f 7
N "1 t!
City, State, and ZIP Code
Country
Country
QGlesoN
USA
USA
G-GA
Email Address Telephone Number
Ernail Address
EMADPpne Number
Bertle L. Fields (812 ) 604-4476
( )
Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge and belief, Is true, correct, and complete as
required by law, and Is prepared In accordance with IC 6-1.1-6.6. A person who knowingly and Intentionally falsifies the value of transferred
real property, or omlts or falsifies any fnformatlori required to be provided, commits a1evel 6 felony.
nM
40'nted-Namo
etle'- ,
Sig nature of Seller
of Seller
Date Signed (mrnldd/yyyy)
Printed Name of Seller
Date Signed (mmJdd/yyyy)
Bertlo L. Flelds
107/08/2026
J. BUYER(S)iGRANTEE(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
Lane D. Wellen
Kylle S. Wellen
Address (number and street)
Address (number and street)
9868 West 450 South
9868 West 450 South
City, State, and ZIP Code
City, State, and ZIP Cade
Owensvllle IN 47665
Owsensvllfe IN 47665
Country
Country
USA
USA
Email Address
Telephone Number
Email Address
Telephone Number
wetlenlane1226@yahoo.com 1
(618 ) 927-1226
((,HIV) 941, `Wgct
Pursuant to IC 6-1.1-12-44, the Sates Disclosure Form may be used to apply for certain dad ctIons. Identify all of those that apply:
YES NO CONDITION
YES NO CONDITION
1. Will this property be the buyer's primary
® 13
0 ❑ 3. Homestead
residence?
❑ 0 4. Solar Energy Heating or Cooling System
® ❑ 5. Wind Power Device
❑ 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
L3 0 6. Hydroelectric Power Device
® �] 7. Geothermal Energy Heating or Cooling Device
Address (number strop
.
IlanCity,
State, and ZIP Cod County
tIr
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 required by law, and [a prepared In accordance with IC 6-1.1-6.6. 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 6 felony. (Note. Both spouse's
fnfomredon, SSMIDrlver's Lfcensa/!D10fherN6m6eris necessary only If a Homestead Deduction Is boingr filed.)
S11 nat!2Lto Buyer Jf
S not a of Bpy
_2i:2,JSpOus6
PrMted Legal 116me of Buyer 1 Sign Date (MWDD/YY)
nle ame o Spouso Wgn Date (MMIDDIYY)
Lane D. Wellen 07/08/2026
Kylle 9. Wellen 07/08/2026
Last 5 Digits of Buyer 1 SSN/Driver's License/010ther Number
Lost 5 Digits of Buyer 213pouse 8SN/Driver's LicensellD/Other Number
Last 5 of SSN:
Last 5 of SSN:
Page 3