Homestead_ResenbeckINDIANA SALES DISCLOSURE FORM SDF ID: Zp�z
D. PREPARER
✓�' �N! Y� S �c� c� ��. 2--i
P2parerolthe Sales Disclosure Form
' 605 SE Martin Luiher King Jr Boulevard
Address (NUm6er and StreefJ
E. SELLER�S) / GRANTOR�S)
Mary Ann Ingler
Seller 7- Name as appears on conveyance document
607 E. Oak
Address (NUm6er and S(reet)
Fort Branch,IN 47648
Gig Srate, and ZIP Code
Page 2
L �GSi �-v j� ,c/\
Title
Southwestern Indiana Land Title
Company
(
Seller 2- Name as appears on conveyance documenf
(NUmbei antl
and
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, "Real Property Sales Disclosure Act".
� �
. i.
Si nature f Seller
Anningler `�( -�Cx-�i0/�.
�ted Name of Seller Sivn Da(e (MM/DDNYYY)
APPLICATION FOR
Brian D.Resenbeck
Buver 7- Name as ap
Address (Number and St�eet)
Owensville, IN 47665
Gtg Srefe, and ZIP Code
�`
Tulanhnne Numher E-Ridll
THE SALES DISCLOSURE fORM MAY BE USED TO APPLY FOR CERTAIN
YES NO CONDITION
0 ❑ 1. Will ihis propeRy be the buyers primary
residence? Provide complete address of prima
residence,inGuding county:
607 East Oak Sireet
Address (NUmber and Sfreel)
Fort Branch, IN 47648 Gibson,
Ciry, State ZIP Code County
0 � 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:
�jrp4 �. 7�0�.1
Add�ess (NUmber and Streeq
G.,., Eusv ,�6 i.�� 471s��1 �l�JCti1
City, Stare ZIP Code County
Under penalties of
complete as requi�
SignaNre of Seller
IDENTIFY ALLI�EMS THAT APPLY
Robin R. Resenbeck
_ Buyer 2- Name as appears
Owensville, IN 47665
FOR THIS PROPERN. IDENTIFY ALL OFSHOSE THAT APPLY.
YES NO CONDITION
� ❑ 3. Homestead
� 4. Solar Energy Heati�/Cnokrfg System
❑ a 5. Wind Power Device
❑ �' 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 contact informafion
6elow. Please see instructions lormore in/oRnation.
Not available in all counties.)
�6-/9-19- �a�._000. 3s�_o�.(�
Pnmary property owner wn(acf name E-ma�l
, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and
iw, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure AcY'. (Note: Spouse
iy an/d Drivers L' ense/Other numbers are`nnot necessary if no Homestead Deduction is being filed.)
�/ �� �_ I �fSCG.�. `��a��.UtecK
Sig ture of Buyer pa se
BrianD Resenbeck �1'�7��IY
Pnnt Legal Name of Buyer 7 S9n Dare (MM/DD/YYYY)
� /�,1
Last 5 digifs ol8uyer 7 Onvers State Last 5 Digrts o7 Soual Secuniy Number
License/ID/Other Number
Robin R Resenbeck ��o2'J�/ L
Pnnf Legal Name of Buyer 2/Spouse � Sign Dare (MM/DD/YYYY)
��. �l •�
Last 5 diglts of Buyer 2 Dnvers State Last 5 Digifs of Soaal Secunry Number
LicenSe/ID/Other Number