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HomeMy WebLinkAboutHomestead_Meyer (2)H. PREPARER Preparer of the Sales Disclosure Form Matthew Jarvis Company Southwestern Indiana Land Title Title Escrow Officer E-mail address matt@swinland.com Address (number and street, city, state, country, and ZIP code) 605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713 Telephone number (812) 425-0055 I. SELLER(S)/GRANTOR(S) Seller 1 — Name as it appears on conveyance document Seller 2 — Name as it appears on conveyance document David Rose Brian Rose Address (number and street) Address (number and street) 1370 W 1200 S 8738 S 450 W City, State and ZIP Code City, State and ZIP Code Haubstadt, IN 47639 Owensville, IN 47664 Country Country United States of America United States of America ele hone Number Email Address elephone Ng3er ,� Email Address p r _ Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of y y knowledge any t 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 intentional) falsifies the value of transferred real roe or omits or falsifies any information required to be provided, commits a Level 5 felony. nature of Printed Name'o`t Seller David Rose Date Signed (mm/dd/ yyyy) 9/15/2026 of Seller Printed Name Brian Rose ate Signed (mm/dd/yyyy) 15/ -u-, J. BUYER(S)IGRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY Buyer 1 — Name as it appears on conveyance document EAddress me as it appears on con PnVocument Chase Meyer 2026 Address (number and street) ber and street) 1410 Sandalwood Ct ood Ct City, State and ZIP Code City, State and ZIP Code C0-ry,4Up ©� Evansville, IN 47720 Evansville, IN 47720 Country United States of America Email Address Telephone Number 7 (8 22) 774-7438 Country United States of America Email Address Telephone Number (812) 455-0449 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 0 ❑ 1. Will this property be the buyer's primary residence? Ff ❑ 2. Does the buyer have a homestead to be vacated for this residence? If yes, provide address: Address (number and street) A - e State, and,�IP Code YES NO CONDITION 10 ❑ 3. Homestead ❑ 0 4. Solar Energy Heating or Cooling System ❑ 0 5. Wind Power Device ❑ 0 6. Hydroelectric Power Device ❑ 0 7. Geothermal Energy Heating or Cooling Device {MUL. ee r - isclosure, to the best of my knowledge and belief, is true, correct, and complete as Under penalties of perjury, I hereby certify that this Sales D 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/ID/Other Number is necessary if a Homestead Deduction is being filed.) Signature of Buyer 1/I Printed Legal Name/ of Buyer 1 r�" Sign Date (MM/DD/YY) Chase Meyer 9/15/2026 Oast 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number SSN: 1 14-7% 1ND: "77g'749 Signature of Buyer 2/Spouse G'^1 , P Id Printed Legal Name of Buyer 2Printed Legal Name of Buyer /Spouse Sign Dat (MM/DD/YY)(MM/DD/YY) Emily Meyer 9/15/2026 Last 5 its of Buyer 2/Spouse SSN/Driver's License/ID/Other Numbe SSN: L/ D� ' joggAl Di'�2 tid®'/l Page 3 rl. PREPARER Preparer of the Sales Disclosure Form Title Matthew Jarvis Escrow Officer Company E-mail address Telephone number Southwestern Indiana Land Title matt@swiniand.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)IGRANTOR(S) Seller 1 — Name as it appears on conveyance document Seller 2 — Name as it appears on conveyance document Jana Mercer Sylvia Rose Address (number and street) Address (number and street) 101 N Polk St 6458 S 175 E Citv. State and ZIP Code City, State and ZIP Code Princeton, IN 47670 Fort Branch, IN 47648 Country Country United States of America United States of America Email Address lephone Number Email 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 intentionally falsifies the value of transferred real property, or by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and omits or falsifies any information required to be provided, commits a Level 5 felony. Sig a re of &flew ,,Ite� ign�a�ture of Sell Print Name of Seller Date Signed (mm/dd/ Printed Name of Seller Date Signed (mm/ddlyyyy) 9/15/2026 yyyy) Jana Mercer 9/15/2026 Sylvia Rose 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 Chase Meyer Emily Meyer Address (number and street) Address (number and street) 1410 Sandalwood Ct 1410 Sandalwood Ct City, State and ZIP Code City, State and ZIP Code Evansville, IN 47720 Evansville, IN 47720 Country Country United States of America United States of America Email Address Telephone Number Email Address Telephone Number (812) 774-7438 (812) 455-0449 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 Z ❑ 1. Will this property be the buyers primary residence? 0 ❑ 3. Homestead ❑ 0 4. Solar Energy Heating or Cooling System ❑ ❑ 2. Does the buyer have a homestead to be vacated for this residence? If yes, provide address: ❑ 0 5. Wind Power Device ❑ 0 6. Hydroelectric Power Device Address (number and street) ❑ Z 7. Geothermal Energy Heating or Cooling Device 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 in with IC 6-1.1-5.5. A person who knowingly and intentionally falsifies the value of transferred real required by law, and is prepared accordance property, or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note: Both spouses information, SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.) S' nature of Buyer 2/Sp Signature of Buyer 1H--&t//O Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY) Printed Legal Name of Buyer 2/Spouse 9�g5/ 026 n Date (MM IYY) Chase Meyer 9/15/2026 Emily Meyer Last 5 Digits of Buyer 1 SSN/Driver's LicenseilD/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number I SSN: SSN: Page 3 H. PREPARER Preparer of the Sales Disclosure Form' Matthew Jarvis Company Cnuth%AIPstArn Indiana Land Title Title Escrow Officer E-mail address matt@swiniand.com Address (number and street, city, state, country, and ZIP code) FnF CF K/Inr in I i ithar Kino Jr Boulevard, Evansville IN United States of America 47713 I. SELLER(S)/GRANTOR(S) Seller 1 — Name as it appears on conveyance document James A. Rose, by Jana M. Mercer, his attorney -in -fact Address (number and street) 6458 S 175 E Citv, State and ZIP Code Fort Branch, IN 47648 Country U 't d St t of America Telephone number (812) 425-0055 Seller 2 — Name as it appears on conveyance document Address (number and street) City, State and ZIP Code Country United States of America nIe aes Email Address Telephone Number Email 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. 5' nature of Sel r ��n�cG2 Gz�� Signature of Seller P nted Name of SellerV Date Signed :(mm:/dd/ Printed Name of Seller James A. Rose, by Jana M. Mercer, his 9 15/2026 attorney -in -fact 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 aocument Chase Meyer Emily Meyer Address (number and street) Address (number and street) 1410 Sandalwood Ct 1410 Sandalwood Ct City, State and ZIP Code City, State and ZIP Code Evansville, IN 47720 Evansville, 1N 47720 Country Country United States of America United States of America Email Address Telephone Number Email Address F(8 phone Number(812) 774-7438) 455-0449 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 EI ❑ 1. Will this property be.the buyer's primary residence? ❑ ❑ 2. Does the buyer have a homestead to be vacated for this residence? If yes, provide address: Address (number and street) City, State, and ZIP Code County Date Signed (mm/dd/yyyy) 9/15/2026 YES NO CONDITION Rl ❑ 3. Homestead ❑ RI 4. Solar Energy Heating or Cooling System ❑ 0 5. Wind Power Device ❑ 0 6. Hydroelectric Power Device ❑ Rl 7. Geothermal Energy Heating or Cooling Device 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 spouses information, SSN/Drivers License/ID/Other Number is necessary.Aa Homestead Deduction is being filed.) Signature of Buyer 1 Printed Legal Name of Buyer 1 Chase Meyer ® V/ (�7 � Signature of Buyer 2/SpousC.�� V Sign Date (MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign i95/20 Date (MM/DDNY) 9/15/2026 Emily Meyer Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number SSN: Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Numbe SSN: Page 3