Homestead_Voltz 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
Jan Ellen Beach
Address(number and street) Address (number and street) T
10226 W US Highway 24
City, State and ZIP Code
City, State and ZIP Code ED 6
Wolcott, IN 47995 Apo
Country Country 1 0 ?0?y
United States of America
the best of my knowledge and belief, is trdizi,/,94f6dand complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies 4{i1e value of transferred
real property,or omits or falsifies any information required to be provided, commits a Level 5 felony.
ig re of Seller
Iry
Signature of Seller
Print d Name of Seller Date signed (mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
JanEllen Beach 4/3/2024
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
Nickole E.Voltz Ashlea N. Brown
Address(number and street) Address (number and street)
72 W 800 S Apt. 7307 72 W 800 S Apt. 7307
City, State and ZIP Code City, State and ZIP Code
Fort Branch, IN 47648 Fort Branch, IN 47648
Country Country
United States of America United States of America
Email Address
apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION 41
0 0 1. Will this property be the buyer's primary residence? El 0 3. Homestead
❑ 2 4. Solar Energy Heating or Co in,,,
❑ 0 2. Does the buyer have a homestead to be vacated for ❑ El 5. Wind Power Device
this residence? If yes, provide address: ❑ p 6. Hydroelectric Power Device
Address(number and street) 0 2 7. Geothermal Energy Heating or Cooling De ce
City, State,ZIP code, and county 26 - -i ' - (02-002. )C Z _02$
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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