HomeMy WebLinkAboutHomestead_Titzer (2)H. PREPARER ,
Preparer of the Sales Disclosure Form
Title
Matthew Jarvis
Escrow Officer
Company
Southwestern Indiana
Land Title
E-mail address
Telephone number
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 ofAmerica 47713
1. SELLER(S)/GRANTOR(S)
Seller 1 — Name aslit appears on conveyance document
Seller 2 — Name as it appears on conveyance document
Mark R. Gogel j
Kimberly D. Lankford-Gogel
Address (number and street)
Address (number and street)
734 W Conwell Dr
734 W Conwell Dr
City, State and ZIP :Code
City, State and ZIP Code
Haubstadt, IN 47639
Haubstadt, IN 47639
Country
Country
United States ofAmerica
United States ofAmerica
Email Address
Telephone Number
Email Address
Telephone Number
:?tA ?S-S 15-71
OQ 39.5 0400
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!
Sippature of Seller
Printed Name of Seller
Date Signed (mm/dd/
r nted Name&f Selle ate Signed (mm/dd/yyyy)
Mark R. Gogel
yyyy)
Kimberly D. Lankford-Gogel 7/24/2026
7/24/2026
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 appear an ent
Herman Titzer
ft
Address (number and street)
Address (number and street)
4207 Foxcroft Way '
111f
City, State and ZIP Code
City, State and ZIP Code 2026
Evansville, IN 47715
Country
United States
Country
ofAmerica
Email Address i
1912
Telephone Number
Email Address A
Dvftoone Number
—40— dgq o
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
❑ 1. Will this property be the buyer's primary residence?
Q ❑ 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling System
Er ❑ 2. Does the buyer have a homestead to be vacated for
this residence? If yes, provide address:
❑ RI 5. Wind Power Device
❑ Q 6. Hydroelectric Power Device
Ad ress (number and street)
—u ® �6®
❑ Q 7. Geothermal Energy Heating or Cooling Device
tea. ��o�c(
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/Drivers
License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
Signature of Buyer 111
Signature of Buyer 2/Spouse
rinted Legal Kam4 of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Herman Titzer 7/24/2026
Last 5 Digits of Buyer 1 SSN/Driver's Lice nseOD/Other Number
SSN: C>8 4S_Q 0L`
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
0 "sG)i_)�
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