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Homestead_Dobbins
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. SELLER(S)/GRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on cony n doc nt Cory G.Smith Address(number and street) Address(number and street) 4827 North Co Road 500 East FB City,State,and ZIP Code City,State,and Z- ' Petersburg, IN 47567 �+ 4.'4?f Country Country °ON— USA CO�QJ� the best of my knowledge and belief,is true,tim,rrect 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 Seller./ Signature of Seller j " / ice' Printed Name o Sell- Dite Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/ddlyyyy) Cory G.Smith 2/21/2025 2/21/2025 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 Hanner R. Dobbins Address(number and street) Address(number and street) 420 South West Street City,State,and ZIP Code City,State,and ZIP Code Haubstadt, IN 47639 Country Country USA apply for certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION O it 1.Will this property be the buyer's primary QX El3.Homestead residence? ❑ Q 4.Solar Energy Heating or Cooling System 2.Does the buyer have a homestead to be vacated ❑ 0 5.Wind Power Device ❑ for this residence?If yes,provide address: ❑ El 6.Hydroelectric Power Device Address(n ember and street) ❑ ❑X 7.Geothermal Energy Heating or Cooling Device City,State,ZIP code,and County 06 30-23 - I -0oo,34G-o©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 Page 3