Homestead_Cottongim H. PREFARER
Pmparerof the Sales Disclosure Form Td|o
Matthew Jarvis Escrow Officer
Company
Address(number and street, oity, state, country and ZIP code)
605GE Martin Luther King JrBoulevard, Evonuxi{|n IN United States of America 47713
|. SELLER(S)/GRANTCJR(S)
Seller 1 -Name ouit appears on conveyance document Seller 2-Name ao\t appears on conveyance document
Phi||ipVK Reinbrecht LeiQho D. Re)nb,echt
Address (number and street) Address (number and street)
704E. EdinboroughCt. 704E. EdinboroughCt.
City, State and ZIP Code City. State and ZIP Code
Haubotadt, |N 47639 Houbotmdt. |N 47639
Country Country
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.
ignatur f �
C4
Printed Name ofSeller Date signed(mnm�u/vm'v) PrintedNad�enfSa||or Date signed(mm/uu/vvvv)
Phi||ipVK Reinbreoht 2/27/2023 Leigho D. Reinbrech� 2/27/2023
- .
J. BUYER(S)83RANTEE(S)-APPL|CAT|ON FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT
Buyer 1 -Name ouit appears un conveyance document Buyer
Jill[N.Cottongim Phillip A. Cattongim i VOV 6
Address(number and street) Address (number a s
1Q88 Warrick Trail,Apt S14 1988 Warrick Trail,', 14�-
City, State and ZIP Code City, State and ZIP Coda
Newburgh, IN 47630 Newburgh, IN 47630
Country Country
United States ofAmerica United States
_ oeso me, �
YES NO CONDITION YES NO CONDITION
E5 O 1. Will this property be the buyer's primary residence? [D O 3. Homestead
O 21 2' Does
O G 4. Solar Energy Heating ur Cooling System
6
this residence? |f yes, provide address: O GD ' Wind Power Device
O 26. Hydroelectric Power Device
Addneon(numberondotree�) O 2 7. Geothermal Energy Heating or Cooling Device
City. State,ZIP code, and county
�`l » ~( ����'\ ~L� �X�/ [}C�(� (-, L� i~ ����]c]
' --"° ^ . _~^ ` - .�� ` `~ ~' (
Under penalties of perjury,|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|C 64.1-5.5.A person who knowingly and intentionally falsifies the value pf