Homestead_Bosecker H. PREPARER
J
Preparer of the Sales Disclosure Form Title
Kelly E Norton Settlement Agent i
Company Email Address
Address(number and street,city,state,country,and ZIP Code)
4799 Rosebud Lane,Newburgh,IN 47630
I. SELLERS)/GRANTOR(S) _T
Sell 1 -Name as it appears on nveyan document
ce d ument Seller 2-Name as appears on conveyance document
Lmi ! I _ Ker
Add ss(number nd st ) Address(number and street)
Cil a 7 l 4- h utne, ,
City, and ZIP Code City,State,and ZIP Code
i.1 5Vi11. / /,J Li77/ 1
Country Country
Email Address Telephone Number Email Address Telephone Number
( ) ( )
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 6-1.1-5.5.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.
ignature of Seller Signature of Seller
cLi--LtAa IAA,. 6)117
Printed Name Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
J TTI 1 i A, 0'• K r 04/27/2023 A 04/27/2023
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY AT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on con yan cum
Darus Bosecker
Address
sss(number and street) Address(number and street) 1)
10477 S.675 E. MAr22
City,State,and ZIP Code City,State,and ZIP Code 2023
Elberfeld,IN 47613 O . •
47.51
Country Country SO
6
US •COVAQ
Email Address
used to apply for certain deductions.Identify all of those that apply: 1
YES NO CONDITION YES NO CONDITION
_� 1.Will this property be the buyer's primary ® 0 3.Homestead
residence? 0 ® 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated O LE 5.Wind Power Device
for this residence?If yes, provide address: 0 ® 6.Hydroelectric Power Device
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
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VI