Homestead_Penner (5)INDIANA SALES DISCLOSURE FORM SDF ID: 2012
� D. PREPARER
--�\'C�LVI �1��—��
Prepa�ero(the Sales Disclosure Form
605 SE Martin �uther King Jr Boulevard
Address(NUmberandSheeq
Evansville, Indiana 47713
Gry, State, and ZIP Code
E. SELLER�S) I GRANTOR(S)
Brian D. Resenbeck
Seller 1- Name as appears on conveyance document
3984 S 700 W
Addiess (NUmber and S[reet)
Owensville, IN 47665
City, State, and zIP Code
Under penalties of
a�mplete as re
���
Brian D. Resenbeck
Pnnted Name of Sell�
F. BU�ERiSnGRAN
.
Page 2
Land Title
Company
Robin R. Resenbeck
Seller 2- Name as appears on conveyance document
3984 S 700 W
Address (Number and Street)
Owensville, IN 47665
Cifv. State. and ZIP Code
hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
� law, d is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure AcY'.
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i9natureo7Sel r /�
a� 27 (¢o� y Robin R. Resenbeck Y�7"��.
Si9n D te (MM/DD/YYYY) Pnnted Name o7 Selle� Sign Dafe (MM/DDNYYY)
APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL ITEMS THAT APPLY
tluyer 7- Name as pe4fs on conveyance oocumenr
67 W 450 S
Address (NUm6er and Street)
� E-mail
THE SALES DISCLOSURE FORM MAY BE USED 70 APPLY FOR CER7AIN
YES NO CONDITION
❑ 1. Will this property be the buyer's primary
residence? Provide complete address of pri
residence, including county:
3984 S 700 W
Address (NUmbe� and S(reet)
,Owensville, IN 47665 1 Gibson
Ciry, State ZIP Code Counry
� � 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide complete
address of residence being vacated, including county:
Address (Number and Street)
City, Sfare ZIP Code Counry
Buyer 2- Name as appears on conveyance documenf
Address (NUm6er and St�eet)
City, Stare, and ZIP Code
¢NS�FOR THI$ PROPERN. ID IFY ALL OF THOSE THAT APPLV.
YES NO CONDITION
�{I ❑ 3. Homestead
❑ � 4. Solar eating/Cooling System
❑ 0 5. Wind Power Device
❑ O 6. Hydroelectric Power Device
❑ 0 7. Geothermal Energy Heating/Cooling Device
❑ 0 8. Is this property a residential rental property?
❑ � 9. Would you like to receive tax statements for this
property via-email? (Provide contacf information
6elow. P/ease see instrucfions for more inlormation.
Not available in all counties.)
oPG /G-3G-�o�-ao3.o�i� O�
Pnmary pmperty owner contact name E-mail
Under penalties of pery'ury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and
complete�s required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note: Spouse
informati�fn..8�ocial Seourity and Driver's LicenselOther numbers are not necessary if no Homestead Deduction is being filed.)
6rdan Lee Penner
Pnnt Legal Name of E
y � $�
Signature of Buyer 2/Spouse
Pnnf Legal Name o; Buyer 2/Spouse Sign Date (MM/DD/YYYYJ
i '� w �
Lasf 5 digifs o(Buyer 7 Orivers State Las! 5 D�grts o/ Soaal Secunry Number Last 5 digits o7 Buyei 2 Dnvers Siate Lasf 5 Digits of Social Secunty Number
LicensellD/Other Number License/ID/O[her Number