Homestead_Brogan H. PREPARER
Preparer of the Sales Disclosure Form Title
Arnie Maslanka Settlement Agent
Company
Bosse Title Company ---
Address(number and street.city,state,country,and ZIP Corti))
4799 Rosebud Lane,Newburgh,1N 47630
I. SELLER(S)IGRANTOR(S)
Seller I-Name as it appears on conveyance document Seller 2--Name as appears on conveyance document
William E.Speicher Rose M.Speicher -_._, .._ _,. --
Address Address(number and street)51 A}
Address(number and street) 5 1 ' ,5 t ROC 1 a�S "
City.stale.and ZIP Code t 7�,t �-y City.state,and ZIP Code -�� �
Haubstadl,IN 47639 , ) {,,(, i `1`+"Y l Fiaubsiadt,IN 47639
Country Country
US US
of my knowledge and belief,is true,correct and complete as
required by law,and Is prepared IOaccor•.nco with IC 6-1.1-5.5.A person who knowingly and Intentionally falsifies the value of transferred
real .rope y,or omits or fat a e . y info mat •n-r ed to bo provided,corn Its a Level 5 felony.
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Amil '�- Si;.Q{P.ofSes
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t - Dale signed(mmlddl
Printed Name of S<, =r Date signed(mmidd/yyyy) Printed Name of Seller 9 yyYy)
William E.Speicher
01/25/2022 Rose M.Speicher 01/25/2022
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer I--Narno as it appears on conveyance document Buyer 2-.Name as it appears on conveyance document
Cynthia M.Brogan Shane E.Brogan
Address(nu ber end street) Address(number an.C tstresO `l
(4-. -City,
i !� �� � City,stale,and ZIP Code
C[ty,state,and ZIP Code !- rt l](_%-tt - (----t(o3ct
tit-0).)i0 S�b'f� � ,�."7'.cB. 5( C Gl u.�s 4 L
ID Country Country
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US
.,
6
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify ail of those that apply.
C YEs NO CONDITION YES NO CONDITION
p Kt O 1.Will this property be the buyer's primary
aq 0 3.Homestead
4D residence? 0 IN 4.Solar Energy Heating or Cooling System
_,� 2.Doss the buyer have a homestead to be vacated
0 0 5,Wind Power Device
k OD rJ
for this residence?If yes, provide address: O ii 6.Hydroelectric Power Device
L✓1 T.Geothermal EnergyHeatingor CoolingDevice
till Address(number and street) Q ®
1064 E Taftown Rd /� `n(1 Fin�y
(� City,state,and VP CodeCount C'VS'-y36-kv - -Goo. 460-vol
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GIBSON COUNTY AUDITOR