Homestead_Gilpatrick H. PREPARER
Preparer of the Sales Disclosure Form Title
Christa D. Tracey 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)IGRANTOR(S)
Seller 1 — Name as it appears on conveyance document Seller 2 — Name as it appears on conveyance document
Elite Companies, Inc., an Indiana Corporation
Address (number and street) Address (number and street)
304 E SR 68
City, State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639
Country Country
United States of America
of my knowledge and belief, is true, correct, and complete as required
by law, and is prepared in accordance w' 6-1.1-5.5. A person who knowingly and intentionally falsifies the value of transferred real property, or
omits or falsifies any i ation re red to be provided, commits a Level 5 felony.
Signature of S er Signature of Seller
Printed Name of Seller Date Signed (mm/dd/ Printed Name of Seller Date Signed (mm/dd/yyyy)
Brooke Traylor, , ,t-. 1Z.kz) i s4( yyyy I --1 7 De-----)
J. BUYER(S)IGRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT AP
Buyer 1 — Name as it appears on conveyance document Buyer 2 — Name as it appea vey document
Joseph A. Gilpatrick
Address (number and street) Address (number and strey
))
4333 Bell Rd, Unit 1114 20
City, State and ZIP Code City, State and ZI de c02,5
Newburgh, IN 47630 Q/eS
Country Country °41Cpv ,/
United States of America 7)..
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 O CONDITION YES CONDITION
CI1. ill this property be the buyer's primary residence? ❑ Homestead 7 , _
for ❑ 4 olar Energy Heating or`l6o ;� ei l
the buyer have a homestead to be vacated _ .
fr.
❑ 2. Does y
this residence? If yes, provide address: 0 5 Wind Power Device
Address (number and street)
❑ 110 6. Hydroelectric Power Device
❑ Geothermal Energy Heating or Cooling De i e \\\
C---
City, State, and ZIP Code County q r --r2- ^ , S l 1
0 2 o o I ` ' 6 Li l 1 -0 24
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
of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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