Homestead_Elpers (47) H. PREPARER
Preparer of the Sales Disclosure Form Title
Kristina Watson Settlement Agent
Company Email Address
Address(number and street,city,state,country,and ZIP Code)
4799 Rosebud Lane,Newburgh, IN 47630
I.SELLER(S)/GRANTOR(S) .P4
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on con em
Troy David Fortune ``��
Address(number and street) Address(number and street)OOC
1812E. 1200S. �?3
City,State,and ZIP Code City,State,and te
Haubstadt,IN 47639 `SON LOVQ
Country Country Zr! ../e
US 7),'q(174-)2al
( )
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.
n re ,Ile je4a _/' Signature of Seller
Printed 1. 11e of Seller /Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Troy David Fortune 12/20/2023 12/20/2023
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
Garrett Elpers Lauren Elpers
Address(number and street) Address(number and street)
11397 S.50 E. 11397 S.50 E.
City.State,and ZIP Code City,State,and ZIP Code
. Haubstadt,IN 47639 Haubstadt,IN 47639
.--' Country Country
US US
i
YES NO CONDITION ES NO CONDITION
8 O 1.Will this property be the buyer's primary O 3.Homestead
t residence? O 10 4.Solar Energy Heating or Cooling System
(� O 2.Does the buyer have a homestead to be vacated 0 ( 5.Wind Power Device
for this residence? If yes,provide address:X 0 ® 6 Hydroelectric Power Device
O ; s( �ulmbe.andststreet),-
trt e t)— Geothermal
0 () 7. Energy Heating or Cooling Device
I Aty,State,andZIP C 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
�) 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
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