HomeMy WebLinkAboutHomestead_TakacsH. 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
I. SELLER(S)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears n ey ce nt
'George Boop
Address umbe a d street)
Address (number and street)
C
ityState, and ZIP Code
t
City, State, and ZIP Code JUA1
tY O 2 tf
Country
Country
USA
E-mail Address
Telephone Number
E-mail Address
GISSON
telephone Number
g.boop5868@gmail.com
(812) 453-5868
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 f Seller
Signature of Seller
Panted Name ofoSeller
Date Signed (mm/dd/yyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
George Boop
05/13/2026
05/13/2026
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
Joshua Franklin Takacs
Gina Nichole Takacs
Address (number and street)
Address (number and street)
106 South Third Street
106 South Third Street
City, State, and ZIP Code
City, State, and ZIP Code
Francisco, IN 47649
Francisco, IN 47649
Country
Country
USA
USA
E-mail Address
Telephone Number
E-mail Address
Telephone Number
jtak77@gmail.com
(812) 664-0574
1 ntak1988@gmail.com
(812) 550-0965
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
OX ❑ 3. Homestead
1. Will this property be the buyer's primary
❑
residence?
❑ FxJ 4. Solar Energy Heating or Cooling System
❑ ❑X 5. Wind Power Device
2. Does the buyer have a homestead to be vacated
❑
for this residence? If yes, provide address:
❑ ❑X 6. Hydroelectric Power Device
❑ 0 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
I� —ao _ /�^� as-1 - J�J
ace- 3- o �'
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/0/0ther Number is necessary only if a Homestead Deduction is being filed.)
nature of Buyer 1
gngture of Buyer 2/ pouse'
oo�A_C"_ ll L I ffA.li7r�
tinted Legal Name of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Joshua Franklin Takacs 05/13/2026
Gina Nichole Takacs 05/13/2026
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
SS 24365
SS 32494
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