Homestead_Kloc I H. PREPARER
Preparer of the Sales Disclosure Form Title
Kelly Norton Settlement Aaent
Company Email Address
Address(number and street,city,state,country,and ZIP Code)
4799 Rosebud Lane, Newburgh,IN 47630
I. SELLER(S)IGRANTOR(S)
Seller 1—Name as It appears on conveyance document Seller 2—Name as appears on conveyance document
Heirs and Devisees named under the Last Will and Testatment of Elisat
Address(number and street) Add s (number sire )
41 E. 1100 S. O07/73 ` , w/ ,
City,State,and ZIP Code City,S and ZIP Code� / / /s)��m
Haubstadt,IN 47639 -T`j'ye C l/ //�1 `7 iD
Country Country
US
Email Address
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 o falsifies any information required to be provided,commits a Level 5 felony.
rljg at of S I CO. �2it
Signatu of Seller Ckzadn
‘1?e-P '4
E Punted Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Selle C, Date Signed(mm//dayyyy)
Donald J.Rhodes, 05/03/2024 (( l .I"t ' 05/03/2024
J. BUYER(S)/GRANTEE(s) -APPLICATION FOR PROPERTY TAX DEDUCTIONS T Y • •T APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appea n e11; nt
Benjamin Kloc
Address E (number and street) Address(number and stet*Y 4 �n'/ 7
..)
610City,State,and ZIP Code City,State,and V/7
Evansville, IN 47725 Q/BSO O -
Country Country - C \
US AUDrT
)
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
010 1.Will this property be the buyer's primary ® 0 3.Homestead
residence? 0 ® 4.Solar Energy Heating or Cooling System
O 2.Does the buyer have a homestead to be vacated 0 I 5.Wind Power Device
7for this residence? If yes,provide address: 0 ( 6.Hydroelectric Power Device
Address(number and street) 0 () 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County �G _ 1 C1 _.11 —3 O 3_Q p 0 3 3 Z _ u
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