Homestead_Resenbeck (2)IND'QNA SNLES DISCLOSURE FORM SDF ID: 2015
D. PREPARER
IRocksan Underhill
� Preparer of (he Sal?s Disclosure Porm
li 605 SE Martin Luther Kin Jr Boulevard
�'� Address (Mumbei antl StreeQ
Evansville, indiana 47713
E. SELLER(S) / GRANTOR(S)
Mark A. Schmit
Seller 7- Name as appears on conveyance document
1011 Peninsula Dr
Address (NUmber and SfreeQ
Gallatin, IN 37066
Ciry, Sta;e, and ZI? Code
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Officer
Company
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Seller 2- Name as appears on conveyance document �
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(Number and StreetJ
City, State, and ZIP Code ��
Numbe�
Under pena�J es of perjury, I hereby certi that [his Sales Disclosure, to the best of my knowledge and belief, is true, correct
and c m � A as r uir by I and ' rep red in accordance with IC 6-1.1-5.5, "Real Property Sales DisclosureiAcY'.
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Sign Nre o; Sel/er Signature o( Seller ;�
Mark A. Schmit � ��--�T�,��1 '��.I
Page 2
E-mail
rrm�eo name or aener Srgn vate (MN✓UU/YYYY) � Ynntetl Name o/ Se!!er Sign Date (MM/DDNYYY)
F. BUYER(S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL ITEMS THAT APPLY
David S. Resenbeck �i
Buyer 7- Name as appeaa on conveyance tlocumenf Buyer 2- Name as appe on nv an e m t ��
3877 W St Rd 768
Address (N�mberand StreetJ Address (NUmberand Stree[, pE � ;
Fort Branch, IN 47648 � 16� 2p�5 i
Cirv State and7lP ['�ule .. ��I
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN
� ❑ 1. Will ihis property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
505 S Hillcrest St.
Address (NUmber and StroeQ
Fort Branch, IN 47648 I Gibson
CIty, Sta.e ZIP Code County
�� � 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:
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FOR THIS PROPERTY. IDEN7IFY
❑ 3.
,�1 4.
�: 5.
�,jd� 6.
`fk� 7.
fd% 8.
p„ 9.
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Homestead
Solar Energy Heating/Cooling
Wind Power Device
Hydroelectric Power Device
Geothermal Energy Heating/C
Is this property a residential re
Would you like to receive fax :
property via-email? (Provide �
below. Please see instruction
N t a 7ab1 � all o f
APPLY.
ia Device
property?
ments for this
vcf info�nafion
more info�nation.
o va� e m c un �es.)
Address (Num6er and Streef) —' �� O O�,;I /�) O a/
Z. �-I� -I al �c��.� . c�
Ciry. State ZIP Code County P�mary property mvne� contact name � E-mail
Under pert�jies of perjury, I hereby�rRrtify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and
comple[e a�/required,by I n�anil ' prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure AcY'. (Note: Spouse
infwmatio�, Socia�S�e ri�n�iver's License/Other numbers are not necessary if no Homestead Deduction is being filed.)
Signature of Buyer 7
David S. Resenbeck I_�— ��� ��"�
ber
License/ID/O.her Number
SignaNre of Buyer 2/Spouse - ��
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Pnn; Legal Name of Buye� 2/Spouse Sign Date (MM/DDNYriJ �
Last 5 digifs of Buyer 2 Onvers State Last 5 Digits o! Social Secunty Number
LicenseAD/Other h'umber �„