Homestead_Hall 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 street)
304 E SR 68
City, State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639
Country Country
United States of America
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 a nformation required to be provided, commits a Level 5 felony.
Signature of S r r Signature of Seller
Printed Name of Seller Date signed (mm/dd/yyyy) Printed Name of Seller ate nt dd/yyyy)
Brooke Traylor. Authorized Signer 10/12/2022 F JJ
J. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL THAT APPLY
Buyer 1 -Name as it appears on conveyance document Buyer 2- Name as it appears on convey®rU d6Mrr W c(
Joshua D. Hall Tabitha K. Hall v,
Address (number and street) Address (number and street) Vhccizzte-e
511 Bishop St. 511 Bishop St. GIBSON COUNTY AUDITOF
City, State and ZIP Code City, State and ZIP Code
Grayville, IL 62844 Grayville, IL 62844
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 YES NO CONDITION
0 0 1. Will this property be the buyer's primary residence? 0 0 3. Homestead
❑ Z 4. Solar Energy Heating or Cooling System
0 ❑ 2. Does the buyer have a homestead to be vacated for ❑ IZ 5. Wind Power Device
this residence? If yes, provide address:
❑ 0 6. Hydroelectric Power Device
Address(number and street) ❑ p 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county
6- /1_/ -ooL( . 81 S- �
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
copy