Homestead_Kell H. PREPARER
Preparer of the Sales Disclosure Form Title
Colleen Dunn Settlement Agent
Company E-mail address (
Regional Title Services
Address(number and street,city,state.country,and ZIP Code)
621 Main St,Suite 201,Vincennes,IN 47591
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Robert C.Greene Gail R.GreeneIL
Address(number and street) Address(number and street) � )��
4042 E White Oak 4042 E White Oak
City state,and ZIP Code City,state,and ZIP Code M,Q y
Haubstadt,IN 47639 Haubstadt,IN 47639
Country 3 2012
Country �,`
US US G/�/n R' r(
E-mail address
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',Airy A.
ITn,
tinder penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,corrfti 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 taffies any information required to be provided, mite 5 felony.
t of 1 s'- r - , may,
p* . Na of ileru� Date signed(mmfdd/yyyy) Printed Name of Seller ll�� '�- - Date signed(mm/ddlyyyy)
Robert C.Greene 04/28/2022 Gail R.Greene 04/28/2022
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
Ana Gloria Kell Raymond Glavin Kell
Address(number and street) Address(number and street)
y e a C . . oc) N y z.2s ace ,-i
City,slate,and ZIP Code City,state,and ZIP Code
Pr i o c d-o vl -1-►V 1-1 16?0 7.",,..c e.-f,., :Z,U. 4J 7( 7 O
Country Country
1- US US
CV
t Pursutiht 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:
'j YES NO CONDITION YES NO CONDITION
Cr). 1.Will this property be the buyer's primary ® 0 3_Homestead
P IX residence? O O 4.Solar Energy Heating or Cooling System
0 i D O 5_Wind Power Device
c D for this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device
1 2.Does the buyer have a homestead to be vacated Address(number and street)
O O 7.Geothermal Energy Heating or Cooling Device
I'',OCo E= K WI
I City.state,ZIP code,and county_ ��� - fit
rI t, LE1 (,`)a -DS--'�-L-t� -Oof `l
--- Under penalties of perjury,1 hereby certify that this Sates Disclosure,to the best of my knowledge and belief,is true,correct and complete
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