Homestead_Madden H. PREPARER
Preparer of the Sales Disclosure Form Title
Kandace Rogers Closing Agent
Company
Address(number and street,city,state, country, and ZIP Code)
4905 Theater Drive, 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
Janene R. Michel Teresa G. Miller
Address(number and street) Address(number:and street)
1524 East 750 South 5 CI ?3 i U,1 L`
City,State,and ZIP Code City.. tale,and ZIP'Code .J
Fort Branch, IN 47648 !
Country Country ������ 3 � 1 (����lfl�
USA USA
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 grope ty,or omits or falsifies any information required to be provided,commits a Level 5 felony.
*)------L-Signa Lire f Seller "f Seller •
c
Prirrd Name of Seller Date Signed(mm/dd/yyyy) 'iZinted Name of Seller Date Signed(mm/dd/yyyy)
Janene.R.Michel March 3, 2023 Teresa G.Miller March 3, 2023
• J. BUYERS)/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
Braydon Scott Madden
Address(number and street) Address(number and s
403 West 3rd Street
City,State,and ZIP Code City,State,and ZIP Co -"LED
Patoka, IN 47666
Country Country
USA -�1 MAR 0$ ?013
for certairw/ '`: .Qi riliS1ll of those that apply:
YES NO CONDITION YES NO CONDIR614/NTy AUDIT i&
1.Will this property be the buyer's primary XC] ❑ 3. Homestead 0/3
0 ❑ residence? Ei El 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated El ❑X 5.Wind Power Device
for this residence? If yes, provide address:
❑X 6. Hydroelectric Power Device
Address(number and street) ❑ 0 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County
26 257_10l-000 -12i-02,0 •
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
f �h
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