Homestead_Robbins H. PREPARER
Preparer of the Sales Disclosure Form Title
Milton Norman Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
25 NW Riverside Drive,Suite 310,Evansville, IN 47708
I. SELLER(S)/GRANTOR(S) FIL-El
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Bert D.Hyneman Ann M. Hyneman MAR 2 b 2U 4 0
Address(number and street) Address(number and street)
6394 N State Rd 65 5-3S/,5 N'i St. 4 1f irf 6394 N State(td 65
City,State,and ZIP Code City,State, �j����\
Hazleton,IN 47640 V { ! /7/C 6 Hazleton, II�P086T74 ' '�'�''t'*;rt 1- "
VA D/�l1 .� uCOUNTY AUDITuR
Country Country
US US
Email 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. _
Signature of Sellej , / Si ature of Seller
b-e 1 . l f J r,�/rt 4 ��,.e t 11' • rsit=• 1r'.t/fir, r A/11 11 Pig--,-1 C
Printed Name of 5 Alter Date Sign(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Bert D.Hyneman /" 7c,20),(-20..(`{ Ann M.Hyneman 03 �; P C) /
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
Shelby Rose Robbins Griffin Alex Robbins
Address(number and street) Address(number and street)
6394 N State Rd 65 6394 N State Rd 65
City,State,and ZIP Code City,State,and ZIP Code
Hazleton, IN 47640 Hazleton, IN 47640
Country Country
US US
Email Address
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
® 0 1.Will this property be the buyer's primary ( 0 3. Homestead
residence? 0 NI 4. Solar Energy Heating or Cooling System
IX) for
Does the buyer have a homestead to be vacated 0 ( 5.Wind Power Device
for this residence? If yes, provide address: 0 Gil 6. Hydroelectric Power Device
Address(number and street) 0 all 7. Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
( 0C- (2- 1 r-r-,nn , 1t- 1 -
Under penalties of perjury,I hereby certify that 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
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