HomeMy WebLinkAboutHomestead_Robb H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew
Escrow Officer
Jarvis
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 conveyance document
Kali R. Lance
Jeremy R. Lance
Address(number and street) Address (number and street)
6340 W. Stalheim Ave. 6340 W. Stalheim Ave.
City, State and ZIP Code City, State and ZIP Code
Owensville, IN 47665 Owensville, IN 47665
Country
ountry
United States of America United States of America
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
}�ign of Sig of IIp
Date signed(mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
t am f S 111/t2e2 22 Kali R. Lance 111/22/2022
Jeremy R. Lance
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
er 1 —Name as i pears on conveyance document
Bu - — ,- - - -. ..pears on conveyance document
Channon Robb ' Jason B.Wright
s n�d street) ••• ess number,•• : -et) jr-LE
209 . Main St. 209 N. Main St.
City, State and ZIP Code City, State and ZIP Code b
Haubstadt, IN 47639 Haubstadt, IN 47639
' Country Country DEL' 7
^) United States of America United States of America 2022
Telephone number E-mail address Ge3 Telephone number
i E-mail address
I
rt YES NO CONDITION ES NO CONDITIO
O 0 ❑ 1. Will this property be the buyer's primary resident ? RI Cl 3. Homestead
y Heating or Cooling System
VC ❑ 2. Does the buyer have a homestead to be vacated for ❑ El 5. Wind Power Device
I this residence? If yes, provide address: ❑ p 6. Hydroelectric Power Device
2, t ❑ �Address(number and stree 7. Geothermal Energy Heating or Cooling Device
300,1 Roe R a
lUnder
ity, State,ZIP code, and county 00� �(� ��
Owansudie, TN t174-65 6;bson o//-3/-. - -
penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct and complete
s 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
ransferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. (Note:Both spouse's
nf ation, SSN/Driv ' Li e e/ID/Other Number is necessary if a Homestead Deduction is being filed.)