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HomeMy WebLinkAboutHomestead_Fischer (2)H. PREPARER Preparer of the Sales Disclosure Form Title Matthew Jarvis Escrow Officer Company E-mail address Telephone number Southwestern Indiana Land Title matt@swinland.com (812) 425-0055 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 appears on conveyance document Daniel A. Moon Jillian C. Moon Address (number and street) Address (number and street) 807 Creek Dr. 807 Creek Dr. 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 elephone Number Email Address phone Number --I' �° �- 32.- 7 q't , It z --`�C"S- 1 -19 „u Nceimuca Us perjury, i nereoy cerury tnis saies uisclosure, 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. �ignare o ell r ignat re eller Printed Name of Seller Date Signed (mm/dd/ Printed Name of Seller WDateigned(mm/dd/yyyy) Daniel A. Moon yyyy) Jillia Moon 26 7/10/2026 J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY y Buyer 1 — Name as it appears on conveyance document Buyer 2 — Name as it appears on conveyance docume John P. Fischer Susan Fischer Address (number and street) t 4 Address (number and street) 407 E Walnut St. 407 E Walnut St. City, State and ZIP Code City, State and ZIP Code ON Fort Branch, IN 47648 Fort Branch, IN 47648 cOUQ°�G, Country Country d/TO United States of America United States of America R Email Address r(812) phone Number Email Address Telephone Number 677-8496 (812) 677-8496 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 0 ❑ 1. Will this property be the buyer's primary residence? d ❑ 3. Homestead ❑ 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: ❑ © 5. Wind Power Device Address (number and street) ❑ 0 6. Hydroelectric Power Device W & txt❑ 0 7. Geothermal Energy Heating or Cooling Device a City, State, and ZIP Code 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/lP/Other Number is necessary if a Homestead Deduction is being filed,) igpature d Buye ign ture of Buyer 2/Spous , ,F rinted Legal Name of Buyer 1 Sign Date (MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY) John P. Fischer 7/10/2026 Susan Fischer 7/10/2026 Last 5 Di its of of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number SSN: i a q% _,7A l�� : ��A � �. � ISSN: % 1 `_7 i n Page 3