Homestead_Rose H. PREPARER
Preparer of the Sales Disclosure Form Title
Company E-mail address
Address(number and street,city,state,country,and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715 .
• 1. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
JENNIFER N. LOESCH CHELSEA LOESCH
Address(number and-street) • Address(number and street)
5620 E 600 North 5620 E 600 North
City,state,arid ZIP Code City,state,and ZIP Code
Patoka, IN.47666-9134 Patoka, IN 47666-9134 __
• Country -.. Country .
.E-mail address -Telephone number E-mail address
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 felony.
Signature of Seller Si nature of Seller ��
Printed Name of Seller Date signed(mm/dd/yyyy) Pn ed-Name of S er Date signed(mm/dd/yyyy)
JENNIFER N LOESCH October 6, 2022 CHELSEA LOESCH October 6, 2022
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
BRADLEY S. ROSE FILED
Address(number and street) Address(number and street)
5620 E 600 North Q.D
City,state,and ZIP Code City,state,and ZIP Code Patoka, IN 47666-9134 OCT 2 4 2022
Country Country
a14Yk
usedto apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1—I 1.Will this property be the buyer's primary 0 3. Homestead
I I residence? 0 -15 4.Solar Energy Heating or Cooling System
6 2.Does the buyer have a homestead to be vacated El5.Wind Power Device
❑ tor this residence? If yes,provide address: 0 -0' 6.Hydroelectric Power Device
Address(number and street) ❑ El- 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county q G _0/ -0 -1- _`oo - coo 53 L1 -01-3
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
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