Homestead_Sparks Jr H. PREPARER
Preparer of the Sales Disclosure Form Title -
Amy B.Pollard Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance d
The Estate of Charles O.Robinson,deceased;subject to the interest of
Address(number and street) Address(number and street) 4
5146S980W �'I
City,State,and ZIP Code City,State,and ZIP Code 0/e ' ?0?
Owensville,IN 47665 SO 7
Country Country �C'O Q
US G'Lj�,G�
( /
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.
ature of Seller Signature of Seller
' to-0_71_ram -
Printed Name of Seller ll-" Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Lauren M.Blake, Q.e,1%.,nc&Ctpre..4 1`�f' 04/02/2024 04/02/2024
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
Jerry L.Sparks,Jr.
Address(number and street) Address(number and street)
5207 S 970 W,PO Box 720
City,State,and ZIP Code City,State,and ZIP Code
Owensville,IN 47665
Country Country
US
( )
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION E NO CONDITION
® 1.Will this property be the buyer's primary 0 3. Homestead
residence? 0 (XI 4.Solar Energy Heating or Cooling System
—
",S 2. Does the buyer have a homestead to be vacated 0 (2) 5.Wind Power Device
`�-� for this residence? If yes,provide address: 0 (21 6.Hydroelectric Power Device
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
2G 0--04 -400 -000. 231-021
Last 5 Digits of Buyer 2/Spouse SSN/Drivers License/ID/Other Number
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OPY
.x Y