Homestead_Lamey (14) H. PREPARER -- - -- -- - _ _ -- -- - --_ _--
Preparer of the Sales Disclosure Form Title
Kelly E Norton Settlement Agent
Company Email Address
Bosse Title Company _ _ .
Address (number and street, city, state, country, and ZIP Code)
4799 Rosebud Lane, Newburgh, IN 47630
I. SELLER(S)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on conveyance document
Address (number and street) j Address (number and street) T
City, State, and ZIP Code City, State, and ZIP Code '~
Country CountryT-1). -
Email Address I Telephone Number Ems Address �� T- one Number
( ���5_ ( )
Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge,._. .• belief, Is true, correct, and complete as
required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly a• ' n ally falsifies the value of transferred 1
real property, or omits or falsifies any information required to be provided, commits a Level 5 1 T
Signature of Seller ' Signature of Seller &
l 1
a6
Panted Name of Seller 1 Date Signed (mm/ddlyyyy) Printed Name of Seller Date (mm/dd/yyyy)
1 10/01/2025 10/01/2025
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 conveyance document
Chad J. Lamey
Address (number and street) Address(number and street)
11538 S. 150W.
City, State, and ZIP Code City, State, and ZIP Code
Haubstadt, IN 47639
Country Country
US
for certain deductions. Identify all of those that apply:
YES NO CONDITION I YES NO CONDITION
1. Will this property be the buyer's primary a 0 3. Homestead
0 0 residence?
0 (X 4. Solar Energy Heating or Cooling System
2. Does the buyer have ahomeste d to be vacated tii 5. Wind Power Device
for this residence? If yes, provide address:
0 ® 6. Hydroelectric Power Device
Address (number and street) 0 p 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County 2[ r 2Z -` 2 _3oo - 00z , 12Z- 02y
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 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. (Note: Both spouse's
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20_Pay20_
Lesser of 1!2 Homestead
vauanon a 535.000
$
SignaWreofPUdilw " Datesigned