Homestead_Rolley 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, Inc.,an Indiana corporation doing business as
Reinbrecht Homes
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
304 E SR 68
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
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signs ure of Seller Signature of Seller
Phillip Reinbrecht, 9/4/2020 9/4/2020
Printed Name of SeUer Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. PPLICATION\FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEM AT P. i.Y
Melissa L. Rolley f'
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyanc ument ` - / I
5312 Jona Gold Ct. ./QZ
Address(Number and Street) Address(Number and Streett) 0eo
Evansville, IN 47725 3eQ0,4
,,. ,
E-mail Telephone Number (/n,_ E-mail
THE SA SURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THA1 A PLY.
_YES NO CONDITION YES NO CONDITION
0 0 1. Will this property be the buyer's primary 0 0 3. Homestead
residence? Provide complete address of primary 0 0 4. Solar Energy Heating/Cooling System
residence, including county:
0 0 5. Wind Power Device
522 S Cathy Dr.
Address(Number and Street) 0 0 6. Hydroelectric Power Device
Princet , IN 47670 Gibson 0 0 7. Geothermal Energy Heating/Cooling Device
Cit,State ZIP Code County 0 0 8. Is this property a residential rental property?
121 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
address of residence being vacs�ed, Including county: below. Please see instructions tbr-rr►e information.
C3-I(� I)c ( /� — // , a►a e in a coup le .
Addre s(Number and, treet) ��cc"11 �,
biedatSV t a IP ill LP11(/ V -
og-
City,State ZIP Code Countyr. Primary property owner contact name E-mail .
5 digits of Buyer 2 Driver's State Last 5 Digits of Social Security Number