Homestead_Deisher H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbigail Moers Escrow Officer
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
Century Home Builders, LLC, an Indiana limited liability company
Address(number and street) Address(number and street)
9408 S US Hwy 41
City,State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639
Country Country
United States of America
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.A person who knowingly and intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
natur eller"`- Signature of Seller
Printed tame of Seller Date signed(mm/dd/yyyy) Printed Name of Seller 1 Date signed(mm/dd/yyyy)
SPM Development, Inc., Member, by 1/7/2022 1/7/2022
Phillip Reinbrecht„ its President
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT P 1 let)
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears c
Douglas C. Deisher Karen K. Deisher
Address(number and street) Address(number and street) JAN 13 2022
408 W.Cleveland Ave. 408 W.Cleveland Ave. /��-_,L
City,State and ZIP Code City,State and ZIP Code ; rezt YYi.7r%rtdJ
Princeton, IN 47670 Princeton, IN 47670
O1B30N COUNTY AUDITOR
Country Country
United States of America United States of America
E-mail address
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES, NO CONDITION YE NO CONDITION
ICY/ 0 1. Will this property be the buyer's primary residence? S 0 3. Homestead
0 El 4. Solar Energy Heating or Cooling System
i: [ 2. Does the buyer have a homestead to be vacated for this 0 El 5, Wind Power Device
esidence? If yes,provide address: 0 El 6. Hydroelectric Power Device
nu ber and tr et) A Civ d _owe_
I 'v 0 El 7. Geothermal Energy Heating or Cooling Device
Yid "fir l - �eJl,�- y -D 5"-- 3 g b-col - 8 5 o 4{
,Gi� State,ZIP code,and county ��j �' o`er "``.-�
Yii4s3L6't .(-1"1(.,-10 ?t\n -)r,ni
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.A person who knowingly and intentionally falsifies the value of
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's