Homestead_Holliman 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 Sy, Princeton, IN, USA,47670
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
David L. Robinson Tina H. Robinson
Address(number and street) Address(number and street)
10322 W 750 S 10322 W 750 S
City,state.and ZIP Code City,state,and ZIP Code
Owensville, IN 47665 Owensville, IN 47665
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.
Signature of Se r _SigrtJ3tureDf Se er / %
�� = Toff /Lt/
Date signed(mm/dd/yyyy) Printed Name of Seller I Date sign d(mmldd/yyyy)
Printed Jame of Seller g I //l S"/�
David L. Robinson IZ/o 6/�2v.�� Tina H. Robinson 1111 0a,,9
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT PPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Damon A. Holliman
Address(number and street) Address(number and street)
10286 W 750 S FIEED-
City,state-and ZIP Code City,state,and ZIP Code DEC 1 3 2022
Owensville, IN 47665 4
Country Country /�
USA R%�ne4lut�`.�iina/
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary
O 0 3.Homestead
O O residence? 0 O 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated
0 C) 5.Wind Power Device
D O for this residence? If yes,provide address: 0 O 6.Hydroelectric Power Device
Address(number and street) 0 p 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 17 -t 6,- 3 c Q -O V c -6 C( O 2(
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
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