Homestead_Conde 'H. PREPARER
Preparer of the Sales Disclosure Form 17;tle
Matthew Jarvis I �scro•a '4ficer
Company
Address(number and street, city, state, country, and/fP i;oda;
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of Arnenc� 47713
I. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document 11 Seller 2 - Name as it appears on conve ce document
Mark D.Chandler I Billie L. Cnandler T
Address(number and street) `.Address tnumber ar,d street)
703 W Conwell Dr ! 703 /)Conwell Dr
44)
City, State and ZIP Code + City, State and ZIP Code Haubstadt, IN 47639 { Haubstadt, IN 47639 —✓q4/ 40
Country 1 Country ��?
United States of America I United States ofAmericaQ/ksio 04
Email Address Telepnone Number Email Address N � Telephone Number
` n _
i. QZ f.
Under penalties of perjury,I hereby certify this Sales Disclosure,t..the best of my knowledge and belief,is true,d` ig,e di comple as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies tl eue of tr s• eed
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. ,\ I
Signature of Seller —1 Sig..ature of Seller
--))
•
Printed Name of Seiler Date signed (mrn'dd/yy,yjj Pr:need Maine of Seller Date signed (mm/ddryyyy)
Mark D.Chandler 1/10/2024 ' Billie L. Chandler I 1/10/2024
J. BUYER(S)/GRANTEE(S)--APPLICATION FOR PROPERTY TAX DEDUCTIONS--IDENTIFY ALL THAT APPLY
Buyer 1 -Name as it appears on conveyance document 1 Buyer 2-Name as it appears on conveyance document
Giselle Conde i Jeremy Jrhnson
Address(number and street) --� —-^- I Address(number and st.eet)
6198 114th St ! 6198 114th St
City,State and ZIP Code ) City, State and ZIP Code
Blue Grass, IA 52726 ' Blue Grass, iA 52726 r.__ ntry---- - .
Country
United States of America - I United States at America
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 r YES NO CONDITION
E 0 1. Will this property be the buyer's primary residence? E ❑ 3. Homestead
- ❑ 10 4. Solar Energy Heating or Cooiing System
0 0 2. Does the buyer have a homestead to be vacated to; E G 5. Wind Power Device
this residence? If yes, provide address:
LI 06. Hydroelectric Power Device
Address(number and street) —�I r; f 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code; and county
26,i g -36 -2-00 - 0o2 .349 -to2i4 •