Homestead_Gillihan H. PREPARER
Preparer of the Sales Disclosure Form Title
Lindsay M. Phelps Searcher
Company
Address(number and street,city,state,country,and ZIP Code)
226 W Broadway St, Princeton, IN, USA,47670 FILED
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Crystal Atkins Richard McEllhiney JUN 0 9 2022
Address(number and street) Address(number and street)
214 S Division St 214 S Division St
City,state,and ZIP Code
City,state,and ZIP Code V)? Atatzt a• >l
Francisco, IN 47649 Francisco, IN 47649 GIBSON COUNTY AUDITOR
Country Country
USA USA
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.
ganlat'ure of eller Signature of Seller ,�} 12�,
..-
,Signature.& 'j;J ?� Date signed(mm/dd/yyyy Printed Name of Sell/er Date signed(mm/dd/yyyy)
Printe'4 me • eller g Date
-D B-Z0 2
Crystal Atkins c)(�-a g-4 Richard McEllhiney
0(0 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
Travis Gillihan
Address(number and street) Address(number and street)
2694 E State Road 64
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670
Country
ountry
USA
E-mail address
( )
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
O O 1.Will this property be the buyer's primary
p 0 3. Homestead
residence? 0 O 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
0 t2d for this residence? If yes,provide address: 0 Cl 6.Hydroelectric Power Device
Address(number and street) O tJ 7.Geothermal Energy Heating or Cooling Device
City,state.ZIP code,and county U—I`3 2'0 -1OZ --O D 0-1 6 4- —O O
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
5