HomeMy WebLinkAboutHomestead_Risinger (3)H.PREPARER
Preparer of the Sales Disclosure Form
Title
Christina Lenfers
Settlement Agent
Company
Email Address
Telephone Number
( 812 ) 421-4000
Bosse Title Comipany
Address (number and street, city, state, country, and ZIP Code)
4799 Rosebud Lane, Newburgh, IN 47630
I. SELLER(S)IGRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
Daniel Hirsch
Address (number and street)
Address (number and street)
207 S. Vine St.
City, State, and ZIP Code
City, State, and ZIP Code
Haubstadt, IN 47639
Country
Country
us
Email Address
Telephone Number
Email Address
Telephone Number
danielalbertoll@icloud.com
( 812 ) 213-6351
( )
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.
Slanature of Seller �
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Signature of Seller
Printed Name of Seller
Date Signed (mm/dd/yyyy)
Printed Name of Seller
Date Signed (mm/ddlyyyy)
Daniel Hirsch
08/05/2026
88/05/2026
J. BUYER(S)IGRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS —1D T LL P Y
Buyer 1 — Name as it appears on conveyance document
Buyer 2 — Name as it appears on conveyancee
Preston Blake Risin er
Address (number and street)
Address (number and street) 6 G��U
1397 W. Cloverdale Ct.
City, State, and ZIP Code
City, State, and ZIP
Haubstadt, IN 47639
GIBS
Country
Country
us
Email Address
Telephone Number
Email Address
Telephone Number
( 812 ) 499-3230
1
1 ( )
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
NO CONDITION
1. Will this property be the buyer's primary
P0 3. Homestead
residence?
K 0
0 ® 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:
0 CO 6. Hydroelectric Power Device
0 ® 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
'9'o� _ 1('� _ �` _ so?_�� - _ �R
City, State, and ZIP Code County
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of m`y knowledge and belief, is true, correct, and complete
as required by law, and is prepared in accordance with IC 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, SSWDrivers LicensMD/OtherNumber is necessary only ifa Homestead Deduction is being filed.)
Signature of Buyer 1 � ,
Signature of Buyer 2/Spouse
Printed Legal Name of Buyer 1 Sign Date (MM/DDIYY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Preston Blake Risinger 8/5/2026
08/05/2026
Last 5 DigitAof Buyer $SN/Driver's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's Lionse/ID/Other Number
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