Homestead_Companik INDIANA SALES DISCLOSURE FORM SDF ID: 2019 Page 2
D. PREPARER
Kristina Watson Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street)
E. SELLER(S)/GRANTOR(S)
SPM Development, Inc. dba Reinbrecht Homes
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
304 E State Rd 68
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639
Sales Disclosure,to the best of my knowledge and belief, is true,correct
and complete ashrequired by law,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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na/,�;of S r /... Signature of Seller
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4,2b-3/ICI)? '
tinted- e-ofSeller Sign Date(MM/DD/YYYY) Printed Name of Seller ate MM/DDNYYY)
F. BYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL IT t�fir iS7-Kenneth R. Companik--- Cynthia J. Companik
Buyer 1- .ame'as a rs- n conveyance document Buyer 2-Name as appears on conveyarpEtc r47nt2019
934 N Lafayette Ave 934 N Lafayette Ave G
Address(Number and Street) Address(Number and Street)
Griffith, IN 46319 Griffith, IN 46319
City,State, and ZIP Code City, State, and ZIP Code
•
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS PROPERTY. IDENTIFY A OF THOSE THAT APPLY.
YES NO CONDITION YE NO CONDITION
❑ 1. Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary —❑ Ing/Cooling System
residence, including county:
1317 W Chukar Hollow ❑ 5. Wind Power Device
Address(Number and Street) ❑ 6. Hydroelectric Power Device
_.__ _.___
Haubstadt, IN 47639 r G__—__—..__..............__ __.___.............._........._son_._ 0 7. Geothermal Energy Heating/Cooling Device
Gibson
City, ZIP Code County 0 0 8. Is this property a residential rental property?
0 State2. Does the buyer have a homestead in Indiana to be 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete operty via-email? (Prove.- -• act information
address of residence being vacated, including county: below. Please see instructions form. : ' formation.
Not available in all counties.)
Address(Number and Street)
'a6-1S _3 6 - 300 -0 oz .-62-02
City,State ZIP Code County rimer),property owner contact name E-mail