Homestead_Speicher H. PREPARER
Preparer of the Sales Disclosure Form Title
Zachary A. Peters Attorney
Company
Address(number and street,city,state,country,and ZIP Code)
5615 E.Virginia Street, Evansville, IN USA 47715
I. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyani nt
William E.Speicher Rose M.Speicher
Address(number and street) Address(number and street)
518 S.8th Ave. 518 S.8th Ave. Q
City,state,and ZIP Code City,state,and ZIP Code C"e
Haubstadt IN 47639 Haubstadt IN 47639 is
Country Country O�es,O 4Q12
USA USA �L
C
E-mail address Telephone number E-mail address OC/C2 lephone n m r
( ) ��)- )
Under penalties of p-'ury,I iereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,4 nd co ete ate/
req •' ed by law,and s prep.red in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies alue of transferred
reap ' or om ,. or falsifies any information required to be provided, mmits a Level 5 felony.
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Printed Name of Sell r Date signed( m/dd/yyyy) Printed Name of Seller Date igned( m/dd/yyyy)
William E.Speiche J_ • �D111y23 Rose M. Speicher a 107
J. BUYER(S)/G TEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDE I ALL THAT APPLY
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears cotieyirce d ument
Christopher W.Speicher
s b
Address(number and street) Address(number and street)
102 N.Weber Dr. Dec
City,state,and ZIP Code City,state,and ZIP At 1 2
Haubstadt IN 47639 G/& .,,,L.„
VZ,J
Country Country �N C r7
USA Coo 1
fltifir,
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 YES NO CONDITION
a ❑ 1.Will this property be the buyer's primary ❑
El 3. Homestead
residence? ❑ 0 4.Solar Energy Heating or Cooling System
❑ ❑ 2.Does the buyer have a homestead to be vacated El 5.Wind Power Device
for this residence? If yes,provide address: ❑ 0 6.Hydroelectric Power Device
Address(number and street) ❑ El 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county •
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
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