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HomeMy WebLinkAboutHomestead_MadisonH. PREPARER Preparer of the Sales Disclosure Form Title Matthew Jarvis Escrow Officer Company i E-mail address Telephone number Southwestern India ia Land Title matt@swinland.com (812) 425-0055 Address (number a id street, city, state, country, and ZIP code) 605 SE Martin Lutli er King Jr Boulevard, Evansville IN United States of America 47713 I. SELLERS)/G NTOR(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 SIR 68 City, State and ZIP 3ode City, State and ZIP Code Haubstadt IN 47639 Country iCountry United States ofAmerica Email Address Telephone Number Email Address Telephone Number dona@rein,brechth mes.com �81,2 — 6e6- 013 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 6A.1-5.5. A person who knowingly and intentionally falsifies the value of transferred real property, or omits or falsifies an information required to be provided, commits a Level 5 felony. Signature of Seller _ Signature of Seller Printed Name of S er FDate Signed (mm/dd/ Printed Name of Seller Date Signed (mm/dd/yyyy) Phillip Reinbrecht, President yyyy) 14/30/2026 J. BUYER(S)/GRAN EE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT AP Buyer 1 — Name as it appears on conveyance document Buyer 2 — Name as it appe s ent McKinley T. Madiso , Sr. ��tn Address (number and 404 N West St street) Address (number and stree, 'Q% O City, State and ZIP Code City, State and ZIP de z(j Princeton, IN 4767 G Country Country QVIV United States ofAmerica Email Address Telephone Number Email AddressTO9 Telephone Number (812) 622-1366 Pursuant to, IC 6-1.1- 2-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply: YES NO CONDITION YES NO CONDITION 0 ❑! 1. Will this property be the buyer's primary residence? 0 ❑ 3. Homestead ❑ 0 4. Solar Energy Heating or Cooling System ❑ 2. Does the buyer have a homestead to be vacated for this re idence? If yes; provide address: ❑ 0 5. Wind Power Device ❑ 0 6. Hydroelectric Power Device Address (number arid street) ❑ 0 7. Geothermal Energy Heating or Cooling Device City, State,and ZIP Code County -- — U? - — OC) I . Sil ii 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 bylaw, ands 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 information, SSN/Driver's License/ID/Other Nut iber is necessary if a Homestead Deduction is being riled.) ig`aturea B ye`r d Signature of Buyer 2/Spouse Printed Legal Na of Buyer 1 Sign Date (MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY) McKinley T.' Mad o , Sr. 4/30/2026 Last 5 Digits of Buy r 1 SSN/Driver's,License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number SSN: _ , 3 Page 3