Homestead_Bush H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbigail Moers rt SGj(v1,.)
Company
Address(number and street,city,state,country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S) ,
Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on conveyance document
SPM Development, Inc.,an Indiana corporation doing business as
Reinbrecht Homes
Address(number and street) Address(number and street)
304 E SR 68, Haubstadt, IN 47639
City,State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639 ,
Country Country
United States of America
E-mail address
Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete as
required by law,and is prepared in ac ordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred real
property,o mits alsifies a • rmation required to be provided,commits a Level 5 felony.
igna re of a isnvwgrratb of Seller
Printed Name - er Date signed(mm/dcVyyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Adam G ,Authoried Signer 1/28/2021 Date
J UYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT AP Y
Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears o „.anveyance document
Gary D. Bush }
Address(number and street) Address (number and street)
4058 S 35 1
Ci , tate and ZIP Code City, State and ZIP Code FEB
nsville, IN 47665 4?O?'
ount Country
nited States merica GI
mail address
roR
Purs 4t to IC 6-1.1-12-44,the Sales 131-i-elos e Fo y be used to apply for certain deduc_ons.Identify all of those that apply:
YZ y NO DITION YES NO C9.DLDLTI.
❑ . Will this property be the buyer's primary residence? r 0 3. Homestead
❑ '1.4 4. Solar Energy Heating or Coo i ste
0 2. Does the buyer have a homestead to be vacated f. ❑ El 5. nd Power Device
this residence? If yes, provide address:
0 El 6. Hydro ctric Power Device
Address(number and street) 0 El 7. Geothermal ergy Heating or Cooling Device
City, State,and ZIP Code County
av2-\\-3 y—300 . 0 • ?k-i- 0 I
Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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