Homestead_Reinbrecht INDIANA SALES DISCLOSURE FORM SDF ID: 2017 Page 2
D. PREPARER
Kathy Masterson Escrow Officer
Prepare(of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 kathy@swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. S LLER(S)/GRANTOR(S)
i n1\- i ( A P- R-C_,( ln br�vin f
• Seller 1-Nam- as appe.rF on •nveyance d• ment, d Seller 2-Name as appears on conveyance document
••dress(Number and Street) Address(Number and Street)
{rlV1(, �-u,,, , (rf` t� 70 .
nder penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct
and co plete as required by law,and is prep.red in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
I i
l k ►' -A_-A-stag 11'_ ' Is. l/
Signature of Seller
/.
'anted Name of Seller Sign Date(MM/D WYYYY) 7 Printed Name of Seller g i.r• •.)- M/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL IT 71H f A- - , • '
oshua S. Reinbrecht AAAA 119J
art-Name a c rs on conveyance document Buyer 2-Name as appears on convey vodingnPOj/
5794 W Old Princeton Rd
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665 y JbIPk
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO CONDIT]
I ❑ 1. Will this property be the buyer's M s primary ( 4 ❑ 3. Homestead
residence? Provide complete address of primary ❑ 4. Solar tnergy eating/Cooling System
residence,including county:
❑ 5. Wind Power Device
5794 W Old Princeton Rd.
Address(Number and Street) ❑ a 6. Hydroelectric Power Device
Owensville, IN 47665 I Gibson ❑ 7. Geothermal Energy Heating/Cooling Device
City State ZIP Code County ❑ 8. Is this property a residential rental property?
❑ p. Does the buyer have a homestead in Indiana to be ❑ � 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete (, property via-email? (Provide contact information
ca
address of residence being vated, including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) .3/ - Soo - 0°Y• 5 36 -o,Z
City,State ZIP Code County Primary property owner contact name E-mail