HomeMy WebLinkAboutHomestead_Toth H. PREPARER -- -- -_____. - - ---- ---1
Preparer of the Sales Disclosure Form s _ - Title � ...tp
Christina Lenfers Settlement Agent
Company Email Address
Address (number and street, city, state, country, and ZIP Code)
4799 Rosebud Lane, Newburgh, IN 47630
I. SELLERS)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears o con y d
Bryan A. Hirsch Elizabeth A. Hirsch
Address (number and street) Address (number and street) I,
6242 S. 325 W_ 6242 S. 325 W. A p C1 n Q
City, State, and ZIP Code City, State, and ZIP Code ' 20?A+
Fort Branch, IN 47648 Fort Branch, IN 476 (1
Country Country GIeSON C
US US
Of• �
�'Oij )
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 or falsifies any information required to be provided, commits a Level 5 felony. '
Signature of Seller 1 SigOa ure of Se of
C:)d (ri -- \-\ a. ---01C/1--
Name of Seller Date Signed (mm/dd/yyyy) Printed me of Seller Date Signed (mm/dd/yyyy)
Bryan A. Hirsch 02/27/2026 Elizabeth A. Hirsch 02_/27/2026
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
Jane_Ellen Toth
Address (number and street) Address (number and street)
308 N. Vine St.
City, State, and ZIP Code City, State, and ZIP Code
Haubstadt, IN 47639
Country -_�^�---- Country US
( )
•
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 YiS NO CONDITION
O 1. Will this property be the buyer's primary 0 3. Homestead
yi,,___ residence? Q ® 4. Solar Energy Heating or Cooling System
O 110 2. Does the buyer have a homestead to be vacated 0 [) 5. Wind Power Device
for this residence? If yes, provide address: 0 ® S. Hydroelectric Power Device
Address (number and street) 0 12 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
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
3