Homestead_Francisco 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
1. SELLER(S)/GRANTOR(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
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.
Signature of Seller Signature of Seller
ffvia..'s�
Printed Name of Se ler Date Sine � n/dd/ Printed Name of Seller -
9 Date Signed (mm/dd/yyyy)
Phillip Reinbrecht, President YYYY)
12/19/2025
J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPL
Buyer 1 - Name as it appears on conveyance document Buyer 2 - Name as it a e o nveyance document
Gianna Raquil Dela Cerna Francisco �`
(number and street) ��h
Address
Address (number an treet)
1737 W Rose Ct. 1,C°
City, State and ZIP Code City, State and ZIP Code d�� A �t ��e�
Y J .JO
Princeton, IN 47670 , ap.- ., '?.
Country
deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
O 1. Will this property be the buyer's primary residence? io ❑ 3. Homestead
❑ El 2. Does the buyer have a homestead to be vacated for ❑ ❑ 4. Solar Energy Heating or Cooling System /-
this residence? If yes, provide address: El 5. Wind Power Device
Address (number and street) El 6. Hydroelectric Power Device
❑ E. 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
y \\ --\ - ' ICO -- . -
Under penalties of perjury, I hereby certify that this Sates Disclosure, to the best of my knowledge and belief, is true, correct, and complete as