Homestead_Quartucci H. PREPARER
Preparer of the Sales Disclosure Form Title
Haley Smith Escrow Officer
Company
Address(number and street,city,state,country, and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conve c docu n
Zenel Saliju
`d s(number and street) Address(number and street) /C
13 S- k) qy 30 ,
City state, nd ZIP Code City,state,and ZIP C. e02#
Country Country 4,
US US CO
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 inf ation required to be provided,commits a Level 5 felony.
nature of Seller n Signature of Seller
Printed Name Seller Date signe /dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Zenel Saliju 5/24/2024
J. BUYER(S)/GRANTEE(S)—APPLICATION F R 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
Suzanne Quartucci
Address(number and street) Address(number and street)
1014 South Main Street
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648
Country Country
US US
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
O O 1.Will this property be the buyer's primary 0 0 3. Homestead
residence? O 0 4. Solar Energy Heating or Cooling System
O Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
or this residence? If yes, provide address: 0 0 6. Hydroelectric Power Device
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county . � - tg_ `Q - I Q` - 000. 0 LIB -D 2_
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
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