Homestead_Santiago 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 appe on conveyance document
Elite Companies, Inc., an Indiana Corporation
Address (number and street) Address (number and street)
304ESR68
City, State and ZIP Code City, State and ZIP Cod j/Q�
40
Haubstadt, IN 47639 0
Country Country 10<75
United States of America C'ieSC�
of my knowledge and belief, is truQ(t6 ' t, 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 valid 'of transferred real property, or
omits or falsifies any information required to be provided, commits a Level 5 felony.
Sig ure of Sell Signature of Seller
C/ite___ -
Printed Name of Seller Date Signed (mm/dd/ Printed Name of Seller Date Signed (mm/dd/yyyy)
Dona Brown, Authorized Signer YYYY)
10/30/2025
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
Antonio M. sario Santiago Liannette Rosario Molina
Address (number and street) Address (number and street)
1709 W Rose Ct. 1709 W Rose Ct.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
United States of America United States of America
Email Address /
YES NO CONDITION YES NO CONDITION
0 ❑ 1. Will this property be the buyer's primary residence? 0 ❑ 3. Homestead
❑ 0 2. Does the buyer have a homestead to be vacated for ❑ 0 4. Solar Energy Heating or Cooling System IA
this residence? If yes, provide address: ❑ 0 5. Wind Power Device
0
Address (number and street) ❑ 0 6. Hydroelectric Power Device
❑ 0 7. Geothermal Energy Heating or Cooling D
elnel
City, State, and ZIP Code County
% - lk -I 3 -100 - Cod • S—3 -02-S -,1
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