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HomeMy WebLinkAboutHomestead_Gogel H. PREPARER Preparer of the Sales Disclosure Form Title Amy B.Pollard Settlement Agent^ --- Company Address(number and street.city,state,country,and ZIP Code) 7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715 I. SELLER(S)/GRANTOR(S) _--_ _ Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document Joshua D.Newton Ep Address(number and street) Address(number and street) L. i i 734 W Conwell Drive 1 L City,slate,and ZIP Code City.state,and ZIP Code Haubstadt,IN 47639 --- Country Country US 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. _ _, a. Sig,re f Seller � - Signature of Seller I -rinsed Nam of Seller Date signed(mm/dd/yyyyJ Printed Name of Seller Date signed(mm/dd/yyyy) Joshua D.Newton 12/02/2022 12/02/2022 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 Mark R.Gogel Kimberly D.Lankford-Gogel Address(number and street) Address(number and street) 12444 S.Brook Dr 12444 S.Brook Dr City,slate,and ZIP Code City,state,and ZIP Code Haubstadt,IN 47639 Haubstadt,IN 47639 — — — --- — - Country C Country Country US US to apply for certain deductions.Identifyall of those that apply:-_ — 1 Cgs 3. Homestead ® 0 4.Will this property be the buyer's primary residence? 0 It 4.Solar Energy Heating or Cooling System 8 ,j 2.Does the buyer have a homestead to be vacated ' 0 a5.Wind Power Device O � for this residence?If yes,provide address: w_ p a6.Hydroelectric Power Device o 4 dress number azistrecoo0 (2 7.Geothermal Energy Heating or Cooling Device '7'1 City,state.ZIP code, d county .�r 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 Page 3 of 5 C OPY • ts.