Homestead_Martin (23) H. PREPARER
Preparer of the Sales Disclosure Form Title
Claire Kincaid Settlement Agent
Company /�•
4799 Rosebud Lane,Newburgh, IN 47630
I. SELLERS)/GRANTOR(9) /I11EJ )
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on yance ocummeennt
Joshua A.Kohlmeyer Shannon R.Kohlmeyer
Address(numberandstreet) Address(number and street) SEP 0 8 ZUl3
1274 E.Tafttown Rd. 1274 E.Tafttown Rd.
City,State,and ZIP Code City,State,and ZIP Code ..
Princeton,IN 47670 Princeton, IN 47670 c/y/Lca
Country Country r:IgSO NCOUNTY AUDITOR
US US
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person ho knowingly and Intentionally falsities the value of transferred
:a e
- rty,or Its or falsifies any Information required to be provi ,commits a Level 5 felony.
of I na of Seller
i• me of slier_ Date Signed(mm/dd/yyyy) P ted Name of Seller Date Signed(mrn/dd/yyyy)
Joshua A.Kohlmeyer 09/01/2023 Shannon R.Kohlmeyer 09/01/2023
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
Trevor John Martin Megan Martin
Address(number and street) Address(number and street)
4333 Bell Rd. 4333 Bell Rd.
City,State,and ZIP Code City,State,and ZIP Code
Newburgh, IN 47630 Newburgh,IN 47630
Country Country
US US
YES NO CONDITION NO CONDITION
1.Will this property be the buyer's primary 0 3. HX 0 omestead
residence? 0 ® 4. Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 (l 5.Wind Power Device
for this residence? tf yes,provide address: 0 ® 6. Hydroelectric Power Device
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
),(-1--1) -2 -k0O-tn(2o . ( 9 -Od4
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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