Homestead_Seib (3) H. PREPARER
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 conveyance document
Mark W.Jorden,Jr. Kathryn Jorden _
Address(number and street) Address(number and street)
1589 E.Warrenton Rd. 1589 E.Warrenton Rd.
City,State,and ZIP Code City,State,and ZIP Code
Haubstadt,IN 47639 Haubstadt,IN 47639
Country Country
US US
required by law,and Is prepared In accordance with IC 6-1.1-5.5.A person who knowingly and intentionally alsifies the value of transferred
real roperty,or omits or falsifies any information required to be provl mits a Level 5 felony.
ture of Seller ..._ _________ S he ofIler ,
iiie
'n d Name of SdMer Date Signed(mm/dd/yyyy) 'n Name of Sell r dd/yyyy)
Mark W.Jorden,Jr. 12/08/2023 Kathryn Jorden �C 12/08 'V
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS I ENTIFY AL iHAWPPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it ape conveyance doci7tfAent
Debra R.Seib Rickie L. LeGrance SOA/e Q
Address(number and street) Address(number and street) O(/N ..
103 Vonna Ln. 103 Vonna Ln. 'rq/j C,..... \i
City,State,and ZIP Code City,State,and ZIP Code 70q
Haubstadt,IN 47639 Haubstadt,IN 47639
Country Country
0 US US
0
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:
r
`p YES NO CONDITION YES NO CONDITION
M O 1.Will this property be the buyer's primary 0 3.Homestead
pX residence? O ® 4.Solar Energy Heating or Cooling System
O
O 2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
( X O
for this residence?If yes, provide nadddre 0 () 6.Hydroelectric Power Device
Address( !r alit street) a .� �"' 0 ID 7.Geothermal Energy Heating or Cooling Device
D City,State,a ZIP Code � 1�'---0County
j Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct,and complete
p4 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
`^oI '
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