HomeMy WebLinkAboutHomestead_PaschalH. PREPARER
Preparer of the Sales Disclosure Form
are
Title
Leah Brown
Settlement A ent
Company
Email Address
Telephone Number
Regional Title Services LLC
closings@regionaltitlelic.com
( 812 ) 759-5555
Address street, city, state, country, and ZIP Code)
7820 Eagle Crest Blvd, Suite 201, Evansville, IN 47715
- - -
_. . -
1. SELLERS)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 9 - Narna a� anoears on conveyance document
Jason F. Brown and Julie R. Clest, as Cc -Trustees f The John W. Brown j_4'O L- Qj(01Hn
Address (number and street) A-FI(X G • WVWA Address (number and street)
1165 E State Road 68 1165 E State Road 68
City, State, and ZIP Code
City, State, and ZIP Code
Haubstadt, IN 47639-8031
Haubstadt, IN 47639-8031
Country
Country j
us
us l
Email Address
Telephone Number
Email Ad
Tess
T ep n Nu ber
( )
janetlbrown46@yahoo.com
( 812 ) 453-5642
Q
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.
St FY�tWe of $ell [ 3 ynawle of aeuei j
rinted Name of Seller Date Signed (mm/dd/yyyy) Pri Name of Seller Date Signed (rnm/dd/yyyy)
Jason F Brown, Co -Trustee 06/02/2026 J net L. Brown 06/02/2026
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENjlFkLqTrT APPLY
Buyer 1 - Name as it appears on conveyance document Buyer 2 - Name as it appears on c eya cum t I
Address (number and street) I Address (number and street)
2659 Effingham Dr J
City, State, and ZIP Code City, State, and ZIP Code
Evansville, IN 47714 U
Country Country
us
Email Address j Telephone Number Email Address U 7I a tuber
mcloven-08@yahoo.com I ( 812 ) 305-8541 ( �n�TrJi=?
Pursuant to IC 6-1.1.12-44, the Sales Disclosure Forth may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1. Will this property be the buyers primary ® O 3. Homestead
® residence? p ® 4. Solar Energy Heating or Cooling System
0 ® 2. Does the buyer have a homestead to be vacated C1 ® 5. Wind Power Device
for this residence? If yes, provide address: p ® 6. Hydroelectric Power Device
Address (number and street) Q ® 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County — e""�
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. SSA/Driver's License/iD/Other Number is necessary only if a Homestead Deduction is being filed.)
Signature of Buyer 1 A n 1 Signature of Buyer 2/Spouse
r+n , i h4X (0 --A � ram% U
Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
William D. Paschal 6/2/2026 06/02/2026
Last 5 Digits of Buyer 1 SSA41PrfveQs Wnse/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
Page 3
H. PREPARER
Preparer of the Sales Disclosure Form Title
Leah Brown Closer
Company
E-mail address
Telephone number
Regional Title Services, LLC
C€osin s Re ionalTltlelIC.COm
(812 ) 812-759-5555
Address (number and street, city, state, country, and ZIP Code)
7820 Eagle Crest Blvd., Suite 201 - Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
1 —Name as ppears c nveyance do ent ---
Seller 2—Name as appears on conveyance document
Address (number d st • et)
Address (number and street)
fir, sta , and Z?POt6de ,r,
City, state, and ZIP Code
Country I
Country
us
US
E-mail address
Telephone number
960)
E-mail address
Telephone number
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
U_P_ -)--T_it,2(.Q4U
Signature of Seller
Print d Name of Seller
Date signed (mm/dd/yyyy)
Printed Name of Seller
Date signed (mm/dd/yyyy)
�- 0P-5t Co--t/'^ke,
Drof")ZOZQ
tn,`
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY
Buyer 1 — Nameaj ii appears on conveyance document Buyer 2 — Name as it appears on conveyance document
Address (number and street)
Address (number and street)
City, state, and ZIP Code
City, state, and ZIP Code
Country
Country
E-mail address
Telephone number
E-mail address
Telephone number
Pursuant to IC 64.1-12-44, 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
1. Will this property be the buyer's primary❑
✓❑ ❑ residence?
❑ ❑r 4. Solar Energy Heating or Cooling System
❑ 0 5. Wind Power Device
2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
❑ [D 6. Hydroelectric Power Device
❑ ❑r 7. Geothermal Energy Heating or Cooling Device
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 6-1.1a.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 6 felony. (Note: Both spouse's
information, SSN/Drivers LkenseAD/OtherNumber is necessary ff a Homestead Deduction is being flied.)
Signature of Buyer 1 Z
Signature of Buyer 2/Spouse
Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Last 5 Digits of Buyer 1 SSN/Driver's LicensellD/Other Number
Last 5 Digits of Buyer 2/Spouse SSNIDriver's License/ID/Other Number
Last 5 of SSN:
Last 5 of SSN
Page 3of5