Homestead_Robling H. PREPARER
Preparer of the Sales Disclosure Form Title
Escrow Officer
Abbigail Moers
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)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyanN1014ent
Household Thoughts, L.L.C.
Address (number and street) c.S)
Address (number and street) t��p
10890 S. US Hwy 41 �4 •r
City, State and ZIP Code City, State and ZIP Code SO, ep V
Haubstadt, IN O
Country �G ��
Country a,,,,,_:.
<
United States of America 9Go lephone number
E-mail address �
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.
"•nature of Seller Signature of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller I Date signed(mm/dd/yyyy)
Brian S. Ellis, Managing Member 9/12/2022
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
Michaela Robling Jacob Russell
Address (number and street) Address (number and street)
4704 Baywood Ct. 4704 Baywood Ct.
City, State and ZIP Code City, State and ZIP Code
Evansville, IN 47725 Evansville, IN 47725
Country
OCountry
United States of America United States of America
(
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
E
O 0 1. Will this property be the buyer's primary residence? I� NO❑ CONDITION3. Homestead
l Y❑S 4. Solar Energy Heating or Cooling System
0 2. Does the buyer have a homestead to be vacated for ❑ E 5. Wind Power Device
go this residence? If yes, provide address: El Elg, Hydroelectric Power Device
41 ❑ p 7. Geothermal Energy Heating or Cooling Device
t Address(number street)
N � 1o� f CA-
C�i y,•S�tate, ZIP code, an 4 y �/�_ }� _ Z�� -Cjpp spa -Ov`�
' �v S N\1�(rjur ��eby cJ QVs Sales Di ( `�' �J
J 011(1 V
Under penalties of perjury, I hereby certify that this Sales Disc osure,to the best of my knowledge and belief, is true,correct and complete
I. 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 spouse's
Si information, SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
�