HomeMy WebLinkAboutHomestead_Robinson (2)H. PREPARER
Preparer of the Sales Disclosure Form
Title
Leah Brown
Settlement A ent
Company
Email Address
Telephone Number
Regional Title Services LLC
closings@regionaltitlellc.com
( 812 ) 759-5555
Address (number and street, city, state, country, and ZIP Code)
7820 Eagle Crest Blvd, Suite 201, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S) JL
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
Matthew V. Himmelhaver
Ashley K. Himmelhaver
Address (number and street)
th
I Address (number and street) ZU26
12280 S 200 E
12280 S 200 E
City, State, and ZIP Code
City, State, and ZIP Code
Haubstadt, IN 47639
Haubstadt, IN 47639
Country
Country ly OUN n'AUDITOp
us
us
Email Address Telephone Number
I Email Address
Telephone Dumber
matthew.himmelhaver@gmail.com ( 812 ) 734-4511
II ashleyhimmelhaver@gmail.com
( ) n"%
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.
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Signature of Seller
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Printed Name of Seller
Date Signed (mm/dd/yyyy)
Printed Name o Iler
Date Signed (mm/dd/yyyy)
Matthew V. Himmelhaver
06/26/2026
Ashley K. Himmelhaver
06/26/2026
J. BUYER(S)IGRANTEE(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
Jeremiah Gail Robinson
Kayla Renee Robinson !
Address (number and street)
Address (number and street)
9127 Poplar Grove Ln
9127 Poplar Grove Ln
City, State, and ZIP Code
City, State, and ZIP Code
Alvaton, KY 42122
Alvaton, KY 42122
Country
Country
US
us
Email Address
Telephone Number
Email Address
Telephone Number
0405JRobinson@gmail.com
( 317 ) 512-7834
kayla.robinson04O5@gmaii.com
( 812 ) 306-8468 I
Pursuant to IC 6-1.1-12-44, the Sales Disclosure Forth may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION
YES NO CONDITION
1. Will this property be the buyer's primary
® ❑
® ❑ 3. Homestead
residence?
❑ ® 4. Solar Energy Heating or Cooling System
❑ ® 2. Does the buyer have a homestead to be vacated
O ® 5. Wind Power Device
for this residence? If yes, provide address:
❑ ® 6. Hydroelectric Power Device
❑ ® 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
City, State, and ZIP Code County
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
transferred real property, or omits or falsifies any Information required to be provided, commits a Level 5 felony. (Note: Both spouse's
information, SSA/Driver's Licensell=fheF Number is necessary only if a Homestead Deduction is being riled.)
511gr} ure of Buyer
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Si aluie of Buyer 2/S99use *? ---
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Pri� ed Legal Name of Buyer 1 Sign Date (MM/DD/YY)
anted Le Na of Buyer use Sign Date (iv QD )
Jeremiah Gail Robinson 6/26/2026
Rayla Renee Robinson ` 06/26/2026
Last 5 Digits of Buyer -- 1ISSN�1._ ritr's License/ID/Other Number l
_ _ _. _. ____1_
Last 5 Digits of Buyer ?/ use S,St�fB{ er's License/ID/Other Number
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