Homestead_Robinson (16) H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbey Moore Closing Agent
Company
Address(number and street,city,state,country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Rodney Coffer Brenda Coffer
A d ess(number and s set) Ad res (n beta d st
State,and ZIP ode Ci tate.and ZIP Cod
1 I r)GrIt 11J L ,S I ��: in(JpNU 11`� L(� � I
rg . k,. IA
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.
Slgnattjre eller Ooldby, S nature of Seller
Printed Name of Sell V U Dal@ Si ned(m dd/yyyy) Printed Name of Seller K\ Date Signed(mm//ddlyyyy)
Rodney Coffer 1-3- Vd l Brenda Coffer 1-' n a�-f
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIF THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on vey c ument
Hagan R. Robinson
Address numberand street) Address(number and street)
—11 E- VEX �t , 14N,State,aZIP C e 1 4City,State,and ZIP Co I6'
..L. ,(- ------)
'DIVA
Country N
for certain deductions.Identify all of tfiJse that apply:
YES NO CONDITION YES NO CONDITION
AJ ❑ 1.Will this property be the buyer's primary 4 ❑ 3. Homestead
residence? ❑ It 4.Solar Energy Heating or Cooling System
❑ pV. Does the buyer have a homestead to be vacated ❑ 5.Wind Power Device
or this residence? If yes,provide address: ❑ 6. Hydroelectric Power Device
Address(number and street) ❑ 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County
26-12-oyl-2aZ-o00 .16C--02 .
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete