Homestead_Gengelbach INDIANA SALES DISCLOSURE FORM SDF ID: 2020 Page 2
D. PREPARER
Angela J. Moers 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)/GRANTOR(S)
SPM Development DBA Reinbrecht Homes
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
304 E SR 69
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 ,
City,State,and ZIP Code City,State,and ZIP Code
(
E-mail Telephone Number E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct
ran comp e equired by law, and is pre ared accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
g
S' n of Seller / Signature of Seller
1I.t /ray l CV 5/7/2020 5/7/2020
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEM I LED
Lee Gengelbach i Libby Gengelbach
t3vyer r-Name as pears on conveyance document Buyer 2-Name as appears on conveyance document
9625 Sidonia Road 9625 Sidonia Road MAY 14 2020
Address(Number and Street) Address(Number and Street)
Tell City, IN 47586 Tell City, IN 47586
E-mail
THE S ES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FO THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YE NO CONDITION
a❑ 1. Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/Cooling System
residence,including county:
❑ 0 5. Wind Power Device
1345 W Chukar Hollow
Address(Number and Street) 0 l l 6. Hydroelectric Power Device
Haubs dt, IN 47639 Gibson! ❑ 0 7. Geothermal Energy Heating/Cooling Device
Ci ,State ZIP Code County 0 0 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be 0 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
aciciress of residence bei ged, including county: below. Please see instructions for more information.
,q6);S ',„l Nti e Not available in all counties.)
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nStreet) [ Ivr T( 39 0.- - 0-.36, 3o0 - Od,,z .7 7.5 - O.Z/
Primaryproperty owner contact name E-mail
City,State ZIP Code County p p y