Homestead_Ashby (2) INDIANA SALES DISCLOSURE FORM SDF ID: 2019 • Page 2
D. PREPARER -
Am1t Pollard Escrow Officer •
Preparer 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 (
E. SELLER(S)I 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 SR 68
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 ,
---- E-mail Telephone Number E-mail
Under penalties of perjury, I h certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct
and as re y law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
ignre of er` • Signature of Seller
12/23/201 12/23/2019.
Printed ame of Seller Si Printed Name of Seller s,�1 Sign Date(MM/DD/YYYY)
F. BU GRANTEE(S)-APPLICATION FOR PROPERTY TAX DE UCTIONS-IDENTIFY; IT r� T�!•r'APPLY
Kimberly N.Ashby
Buyer 1-Name as appears on conveyance document Buyer 2-Name as-r'-ars on conveyane ument
3314 W Broadway St t
Address(Number and Street) Address(Number and Street
Princeton,
N
.
E-mail Telephone Number G�� - - E-mail
THE ALES DISC RE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIO HIS PROPER ALL OF THOSE THAT APP
ti YE CONDITION . YE NO CONDITION _
❑ 1. Will this property be the buyer's primary 0 3. Homestead
residence? Provide complete address of primary 0 p 4. Solar Energy Heating/Cooling System
residence, including county:
0 il 5. Wind Power Device
2548 W Jill Dr.
Address(Number and Street) 0 l 6. Hydroelectric Power Device
Princeton, IN 47670 __...___.......__.....___............_..._.......................__-__.._........._...._.....__._.._........_.-Gi•son' 0 0 7. Geothermal Energy Heating/Cooling Device
Ci`y, State ZIP Code Count 0 0 8. Is this property a residential rental property?
4'1 , ❑ 2. Does the buyer have a homestead in Indiana is be 0 2 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide co plete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more informati n.
Not available in all counties.)
Address(Number and Street) •
A.Q.-. 1 1—I Ey I 0 I— W-6 .Ls)\—\\—O17
ID/Other Number