Homestead_Naranjo H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
Company
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2— Name as it appears on conveyance document
J.C.N. LLC, an Indiana limited liability company
Address(number and street) Address (number and street)
2524 E. Nowaskie Rd.
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City, State and ZIP Code City, State and ZIP Code j
Vincennes, IN 47591 ✓q ��,�
Country Country ] N tY1
United States of America G 4c4 2021
Email Address `
best of my knowledge and belief, is true, correct&tad plete 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 f transferred
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony.
. . .to - of II) Signature of Seller
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P 'nted Name of Seller Date signed (mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
John F. Nowaskie, President 1/25/2024
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
Noemi Crystal Naranjo
Address (number and street) Address (number and street)
1763 W 450 N
City, State and ZIP Code City, State and ZIP Code
Patoka, IN 47666
Country Country
United States of America
Email 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:
YE)5. NO CONDITION YES NO CONDITION
le ❑ 1. Will this property be the buyer's primary residence? (� ❑ 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling System
0 El 2. Does the buyer have a homestead to be vacated for 0 p 5. Wind Power Device
this residence? If yes, provide address:
❑ El 6. Hydroelectric Power Device
Address (number and street) 0 El 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county
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