Homestead_Dilbeck H. PREPARER
Preparer of the Sales Disclosure Form Title `
Matthew Jarvis - Escrow Officer
Company
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyance document
George R. Robinson
Address (number and street) Address(number and street) '4:1
202 S Hillcrest
City, State and ZIP Code City, State and ZIP Code A-
es
Branch, IN 47648 F8o
Country Country 0/4,S
6'�
United States of America 04,-
Email Address
knowledge and belief,is true,'i05 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%d sferred real property,or
omits or falsifies any information required to be provided,commits a Level 5 felony.
4.Sign r of Seller etre,;_ew_ti Signature of Seller
Printed Nam of Seller Date Signed(mm/ddl Printed Name of Seller Date Signed (mm/dd/yyyy)
George R. Robinson YYYY)
2/4/2025
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
Bentley Dilbeck
Address(number and street) Address(number and street)
9512 W 400 S
City, State and ZIP Code City, State and ZIP Code
Owensville, IN 47665
Country Country
United States of America
certain deductions.Identify all of those: at:,•x�'+"x
Y7NO CONDITION YEy NO CONDITION P.
❑ . Will this property be the buyer's primary residence? '� 0 3. Homestead
❑ t 2. Does the buyer have a homestead to be vacated for 0 RI 4. Solar Energy Heating or Cooling System
this residence? If yes, provide address: 0 El 5. Wind Power Device
Address(number and street) 0 El 6. Hydroelectric Power Device
❑ El 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
-VS— -102---000 . cr4-2- 026_