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Homestead_Heichelbech
'H. PREPARER Preparer of the Sales Disclosure Form Title - Sona Welch-Jackson Paralegal Company Address(number and street,city,state,country,and ZIP Code) 1771 W. Diehl Road, Suite 120, Naperville, IL 60563 I. SELLER(S)/GRANTOR(S) Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on cony A ument Jeanette Heichelbech Address(number and street) Address(number and street) 1105 W Morton ST APT 411 '4',4 City,State,and ZIP Code City,State,and ZIP Code OCl Oakland City, IN 47660 _ 3 Country Country /e 0 J t\) United States SO,L 10�3 Email Address 'tlii-* ' ( ) Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,Is tF�g, 're ,and complete as required by law,and is prepared In accordance with IC 6-1.1-5.5.A person who knowingly and Intentionally falstf a value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. 7 Si.nature of Seller Signature of Seller .42114A.7 `'rinted Name of Seller Date igned m/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy) Jeanette Heichelbech 1,e 4S 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 Heichelbech Megan Heichelbech Address(number and street) Address(number and street) 6967 E State Road 168 6967 E State Road 168 City,State,and ZIP Code City,State,and ZIP Code Fort Branch, IN 47648 Fort Branch, IN 47648 Country Country United States United States Email Address YES NO CONDITION YES NO CONDITION 1.Will this property be the buyer's primary © 0 3.Homestead residence? 0 © 4.Solar Energy Heating or Cooling System © 2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device for this residence? If yes, provide address: 0 j 6.Hydroelectric Power Device Address(number and street) Q Q 7.Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County be 7/ ' I�-.3 oo- 0 0 0 3)- - OO/