Homestead_Weber (14) H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
i Company
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conv ace ument
Richard Tepool
Address(number and street) Address (number and street)
509 S 8th Ave ..//,
City, State and ZIP Code City, State and ZIP Code tip
Haubstadt, IN 47639 , 0/e ?a
'47
Country Country UN
United States of America COGQ
E-mail address
'0
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 Sel er Signature of Seller
Printed ‘lame of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
Richard Tepool 6/8/2023
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears on cony=,.•n. •C'cum 1 i�
van Webe Alan Weber
`Address (number and street) Address (number and street)
417 Bradley Dr. 417 Bradley Dr. JUN 1 4 z023
City, State and ZIP Code City, State and ZIP Code matyy,�
Haubstadt, IN 47639 Haubstadt, IN 47639 �l�rlr�rc�
Country Country GIBBON COUNTY AUDIO p
United States of America United States of America
E-mail address
Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YE fl C- N ION
El 0 1. Will this property be the buyer's primary residence? Z 0 3. Homestea
❑ El 4. Solar nergy Heating or Cooling System
0 El 2. Does the buyer have a homestead to be vacated for ❑ Z 5. Wind Power Device
this residence? If yes, provide address:
❑ Z 6. Hydroelectric Power Device
Address (number and street) 0 0 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county
.+ 4 • 43- o6 _ •2oO'000. 777-oO?
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true,c• ,.ct and complete
as required by law, and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifie4 he'e a.,a of
transferred real property, or omits or falsifies any information required to be provided,commits a Level 5 felony. (No ii: o,f,s:- e's
information, SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.) r' `r .
.
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