HomeMy WebLinkAboutHomestead_Jackson (5) 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 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 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 informatio uired to be provided, commits a Level 5 felony.
Signature of Seller ) Signature of Seller
e e
Printed Name of Sr Date Signed (mm/dd/ ~ Printed Name of Seller Date Signed (mm/dd/yyyy)
Phillip Reinbrecht, President YYYY)
3/2/2026 A.-74
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 conveyanc
Kevin Jackson Kezia Loren Jackson 4f44 0
Address (number and street) Address (number ands eet) 20�6
451 Jeanette Benton Dr 451 Jeanette Benton D
City, State and ZIP Code City, State and ZIP Codg3S6,v Q
Evansville, IN 47713 Evansville, IN 47713 CO(7,;-,v 4.4.:}13----L.) .
Country Country 'q(JI
United States of America United States of America ,
-
Email Address
YES NO CONDITION YES NO CONDITION -.
El ❑ 1. Will this property be the buyer's primary residence? Z ❑ 3. Homestead i i``
0 X 2. Does the buyer have a homestead to be vacated for ❑ 0 4. Solar Energy Heating or Cooling System
this residence? If yes, provide address: ❑ 0 5. Wind Power Device
Address (number and street) ❑ El 6. Hydroelectric Power Device
0 RI 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
Ct__C - '\-- --- \ Cf2 - CCI--k Q -(01 _
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
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