HomeMy WebLinkAboutHomestead_Goedde (5)H.PREPARER
Preparer of the Sales Disclosure Form
Title
Abbey Moore
Closing Agent
Company
E-mail Address
Telephone Number
Columbia Title, Inc
abbey@columbiatitlegroup.com
(812) 471-8563 ext. 400
Address (number and street, city, state, country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
1. SELLER(S)/GRANTOR(S)
Seiler 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
Joshua White
Dana White
Address (number and street)
Address (number and street)
2616 Antilles Drive
2616 Antilles Drive
City, State, and ZIP Code
City, State, and ZIP Code
Evansville, IN 47725
Evansville, IN 47725
Country
Country
USA
USA
E-mail Address
Telephone Number
E-mail Address
Telephone Number
coalhogl2@gmail.com
(812) 893-4354 1
devans04@aol.com
(812) 708-2964
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
Signature of Seller
Printed Name of Seller
Date Signed (mm/dd/yyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
Joshua White
05/01/2026
1 Dana White
05/01/2026
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
BrookeU Goedde
MarcW%Vincent
Address (number and street)
Address (number and street)
730 Bayard Park Drive
730 Bayard Park Drive
City, State, and ZIP Code
City, State, and ZIP Code
EVANSVILLE, 1N 47713
EVANSVILLE, IN 47713
Country
Country
USA
USA
E-mail Address
Telephone Number
E-mail Address
Telephone Number
bmgoedde@gmail.com
(812) 215-9174
marcvincent7910@gmail.com
(812) 319-4098
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
YES NO CONDITION
O 1. Will this property be the buyer's primary
❑X ❑ 3. Homestead
residence?
❑ 4. Solar Energy Heating or Cooling 5�2 co
r T, C'V
❑ ❑X 5. Wind Power Device W N
2. Does the buyer have a homestead to be vacated
❑
for this residence? If yes, provide address:
❑ 0 6. Hydroelectric Power Device
❑ 0 7. Geothermal Energy Heating or C aevice��
Address number and street) )
�s� Q
City, State, ZIP code, and County
Under penalties of perjury, 1 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
information,. SSN/Driver's LicenseAD/Other Number is necessary only if a Homestead Deduction is being filed.)
Signatureu er1 ,
Sign re uyer
Printed Legal Name of Buyer 1 Sign Date (MM/DD/Yy)
Printed Lega a of Buyer 2/Spouse Sign Date (MM/DD/YY)
Brooke tGoedde 05/01/2026
Marc Vincent 05/01/2026
Last 5 Digits of Buyer 1 SSN/Driver's License/[D/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
SS50467
SS39229
Page 3
K PREPARER
Preparer of the Sales Disclosure Form
Abbey Moore
Title
Closing Agent
Company
Columbia Title, Inc
E-mail Address
abbey@columbiatitlegroup.com
Telephone Number
(812) 471-8563 ext. 400
Address (number and street, city, state, country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Joshua White
Seller 2 — Name as appears on conveyance document
Dana White
Address (number and street)
2616 Antilles Drive
Address (number and street)
2616 Antilles Drive
City, State, and ZIP Code
Evansville, IN 47725
City, State, and ZIP Code
Evansville, IN 47725
Country
USA
Country
USA
E-mail Address
coalhog12@gmail.com
Telephone Number
(812) 893-4354
E-mail Address
devans04@aol.com
Telephone Number
(812) 708-2964
Under penalties of perjury, 1 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
Signature of Seller
RiWd Name of Seller
Joshua White
Date Ji n d7 d/yyyy)
u ((�
Printed Name of Seller
Dana White
Date
ned m Uddlyyy)
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY
Buyer 1 — Name as it appears on conveyance document
Brooke M. Goedde
Buyer 2 — Name as it appears on conveyance document
Marc W. Vincent
Address (number and street)
Address (number and street)
City, State, and ZIP Code
City, State, and ZIP Code
Country
Country
E-mail Address
bmgoedde@gmail.com
Telephone Number
(812) 215-9174
E-mail Address
1 marcvincent7910@gmail.com
Telephone Number
812 319-4098
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
YES NO CONDITION
❑ ❑ 3. Homestead
❑ ❑ 4. Solar Energy Heating or Cooling System
❑ ❑ 5. Wind Power Device
❑ ❑ 6. Hydroelectric Power Device
❑ ❑ 7. Geothermal Energy Heating or Cooling Device
1. Will this property be the buyer's primary
❑ ❑ residence?
2. Does the buyer have a homestead to be vacated
❑ ❑ for this residence? If yes, provide address:
Address (number and street)
City, State, ZIP code, and 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
Information, SSN/Driver's License/ID/Other Number is necessary only if a Homestead Deduction is being filed.)
Signature of Buyer 1
Signature of Buyer 2/Spouse
Printed Legal Name of Buyer 1 Sign Date (MMIDDM')
Brooke M. Goedde
Printed Legal Name of Buyer 2/Spouse Sign Date (MMIDDIYY)
Marc W. Vincent
Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
Page 3