Homestead_Ziliak H. PREPARER
Preparer of the Sales Disclosure Form Title
Kandace Rogers Closing Agent
Company
Address(number and street,city,state,country,and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLERS)/GRANTOR(S) FitSeller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance docu/IIJj
Garrett W. Elpers Lauren M. Elpers c
Address(number and street) Address(number and street) FEE?
1 3 ?Q?
1812 East 1200 South 1812 East 1200 South
City,State,and ZIP Code City,State,and ZIP Cod4'Z
ue
aubsry dt, IN 47639 Hcaaubsunt'ttadt, IN 47639/9SON CO 2 y�.1
USA USA TOR
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.
Sign ure of Seller Sig lure of Seller
7--f .--- lilt ... y_.....
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Printed Name of Seller Date Signed(mn✓dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Garrett W. Elpers 02/09/2024 Lauren M. Elpers 02/09/2024
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
Lauren Ziliak Frank Durchholz
Address(number and street) Address(number and street)
11397 South 50 East 11397 South 50 East
City,State,and ZIP Code City,State,and ZIP Code
Haubstadt, IN 47639 Haubstadt, IN 47639
Country Country
USA USA
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
1.Will this property be the buyer's primary ❑X ❑ 3. Homestead
X❑ ❑ residence? 0 X❑ 4.Solar Energy Heating or Cooling System
� ,�. Does the buyer have a homestead to be vacated 0 ❑X 5.Wind Power Device
❑ � for this residence? If yes,provide address: ❑ ❑ 6.Hydroelectric Power Device
Address(number and street) ❑ ❑X 7.Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County -Z3 -rO1-'.QD- 00 I , 129 _02`l
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