Homestead_Fryman H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis 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
SPM Development, Inc., an Indiana corporation doing business as
Reinbrecht Homes
Address (number and street) Address (number and stye .
304 E SR 68 •4:
City, State and ZIP Code City, State and ZIP Cod$,# , ,,,,, ;�
Haubstadt, IN 47639 ;I '„N ;, iV3l3j s.4s`'
Country Country 'SS TT ./
United States of America „4,'
1'.
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 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.
,z1aMre of Sell Signature of Seller
Printed Name o Seller Date signed(mm/dd/yyyy) Printed Name of Seller I Date signed (mm/dd/yyyy)
Dona Reinbrecht-Brown,Authorized 3/24/2022 3/24/2022
Signer
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY AI T APPLY
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appe on o�ieya� cument
Wesley Dean Fryman Kelly Lynn Fryman � - �!
Address(number and street) Address (number and street)M
728 County Road 110 E. 728 County Road 110 E. AR 31 202Z
City, State and ZIP Code City, State and ZIPe.
Ellery, IL 62833 Ellery, IL 62833 G/BSOiy`e-el c� - teN
.-"?
Country Country �VHTYditi T
United States of America United States of America O
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 YES NO CONDITION
El ❑ 1. Will this property be the buyer's primary residence? El ❑ 3. Homestead
❑ El 4. Solar Energy Heating or Cooling System
❑ El 2. Does the buyer have a homestead to be vacated for ❑ El 5. Wind Power Device
this residence? If yes, provide address: ❑ El 6. Hydroelectric Power Device
Address(number and street) ❑ El 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code, and county
r • ta Lt -- ' - 10(- 003 .s1---1q-oa'-1
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