Homestead_Robinson (8)c
Preparer ofthe Salu Ditt'losure Fo'm
�9 N. Hart St. PO Box 13
rcss(xumbe�ond sneey
rinceton IN 47670
City, State, and ZIP Code
E. SELLE
Sel/er 1- Name as appears on convryonce document
�s- , r',�S'i,S..S� .G.��
Address(Numberand5treetJ c
OwPnsville IN 47665
liry, SmtG and ZIP Code
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rn:
Hall Partenheimer & Kinkle
Company
E-moil
Amber l. Scheller
Seller 2�,VOme os oppeors on conveyonce document
fl934 W. A4' 1��.,�_�j%% . S. n/2 ��v,i
Address (Vurnber and 5[ree[J
Owensville. IN 47R65
Ciry, Smte, and ZIP Lode ,
Under penal[ies of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is tne, correct
a complete as re ire9p _d by law, and is prepared in accordance with C-1.1-5. �"Real � pgrty Sales Disclosure Act".
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�'�,igpamre o �Seller Signoture o(Seller
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Je;aes_P S�heller Amber L. Scheller
F. BUYE
-APPLICATION FOR
Adam C Robinson
'Buyer 1- Name as appears on ronveyanre do�'ument
407 W: Warrick Lot 7
Addrea (Number and SlreetJ
nsville IN 47665
Smte, and ZIP Code
E mai/
Buyer 2� Nome os appears on mmeyoncr document
Address (Number ond StreeQ
Ciry, Smte, and ZlP Code
Teleohone Number
TNE SALES DISCLOSURE FORM MAY BE USED TO APPLV FOR CERTAIN DEUUCfIONS FOR THIS PROPERTY. IDENTI FY ALL OF TNOSE THAT APPLY.
Q✓ � 1. Will this property be the buyer's primary
residence? Provide complete address of primaiy
residence, inciuding county:
SRQ1 S State Road 'I65
Addres (Num6er and SneeQ
Owensville IN 47665 Gibson
Ciry, Smte ZIP lode Caunp.
� Q 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Address (Num6era� Stree[J
'Ciry. Smte ZIP Cede Counry
Q � 3. Homestead
� Q 4. Solar Energy Hea[ing/Cooling System
� ✓� S. Wind Po�ver Device
� 0✓ 6. Hydroelec[ric Power Device
❑ ❑✓ 7. Geothermal Energy Heating/Cooling Device
� �✓ 8. Is this property a residential rental properry?
� �✓ 9. Would you like [o receive tax statements for this
property via e-mail? (Provide conmct injormation
belo�v. Please see ins[rudions for mare information.
Not available in all counties.)
a�- ��-� _ �oa �o .50 � oal
Adam C. Robinson
mnmct name
Under penalties of perjury, l hereby certify that [his Sales Disdosure, to the best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Ac[". (Note:
Spouse informadon, Social curity and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.)
amreo(Buyerl � SigimNreo/Brry•er2/Spouu
Pnnred fegal Name of Buyer 1 Sign Date (MM/DD/1'IY1�
�Last � digi[s a B yer ] Dnver's Smte Last 5 Digits ofSocial Security Num6er
License/ID/O[her Number
Pnn[eJ Legal Nome o( Buyer?/Spouse Sign Dan (MN/DO/YYY"Yj
Las[ 5 digifs of Buyer 2/Spouse Oriver's Smte Las[ 5 Digiu of Sociol5ecuriry
Number Lirense/1D/OtherNum6er