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HomeMy WebLinkAboutHomestead_Kielb 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 app onveyance document Jamie Whitfield Address (number and street) Address (number and street) .6 301 S 4th Ave A, 44) City, State and ZIP Code City, State and ZIP Code O? Haubstadt, IN 47639 ›c Q �D Country �j ��' Country eSp� ch4/Q United States of America Email Address my knowledge and belief, is true, c©rfect, 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. XSig ture of,Seller Signature of Seller P d Name of Seller Date Signed (mm/dd/ Printed Name of Seller Date Signed (mm/dd/yyyy) Jamie Whitfield yyyy) 3/10/2026 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 Megan Marie Kielb David Paul Kielb Address (number and street) Address (number and street) 206 N. Church St. 206 N. Church St. City, State and ZIP Code City, State and ZIP Code Fort Branch, IN 47648 Fort Branch, IN 47648 Country Country United States of America United States of America Email Address YES NO CONDITION YES NO CONDITION 2 ❑ 1 . Will thisproperty be the buyer's primary residence? El ❑ 3. Homestead 2 ❑ 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: ❑ RI 5. Wind Power Device ddress (number and street) ❑ 6. Hydroelectric Power Device 3 1 S 4th Ave. El 7. Geothermal Energy Heating or Cooling Device City, St a , and ZIP Code County Haubstadt, fN 47639 Gibson ()b- ' 9 - '3 ( _ 3 -- CI do I1-1I ^ 00 9 Underpenalties ofherebycertify I perjury, I 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