Homestead_Biggs H. PREPARER I
Preparer of the Sales Disclosure Form Title
Claire Kincaid Settlement Agent
Company /�
�/
4799 Rosebud Lane, Newburgh, IN 47630
I. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on nveyance document
Household Thoughts, L.L.C.
Address(number and street) Address(number and street) IL
10890 S US Hwy 41 4,4e2((---),\
City,State,and ZIP Code City,State,and ZIP Code
Haubstadt 47639 Oec
Country Country 1 f
US n`_/ O'� J
puz, ( )
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and bete{ .correct,and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionall Qt the value of transferred
rea property,or omits or falsifies any information required to be provided,commits a Level 5 felony. R
nature of Seller Signature of Seller
rin d Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Brian S. Ellis, 12/04/2023 i 12/04/2023
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
Madison Biggs
,�dd.-e�r,nd�O ;treat) I^� D� Address(number and street)
fl 1.- Vh41-{r1r p O Ir
Nt0
Inngd IvP i H fCoouunttry / 4-11 I I City,State,and ZIP Code
L• Country
US
( �� �
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 E XNO CONDITION
01.Will this property be the buyer's primary O 3. Homestead
residence? O 51 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
, for this residence? If yes,provide address: 0 ad 6. Hydroelectric Power Device
Address(number and street) 0 2 7. Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
26- a—i8-303 -00° . �i) -vim • __
3