Homestead_Reinhart •
H.PREPARER . ...
Preparer of the Sales Disclosure Form Title
Payge Marx Escrow Officer
Address(number and street,city,state,country,and ZiP Code)
7412 Eagle Crest Blvd Evansville,iN 47715
I. SEL.LER(S)/GRANTOR(S) ... •• . .
Seller 1—Name as ft appears on conveyance document
Seller 2—Name as appears on conve ante document
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-Address(numberand stnset) Address(number and street)� /l'fr ( Ln Site— 13\ City,state,and ZlP Coda
City,state,and ZiP Code
EY:I f-\S ki; 1\e, iN y-1—l5 4 Country •1 N 05 2024
Country Us
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Under dpenaides
law of penury,(hereby Certify
nee wiith ICles iscloSure,to the best of B 1 1-5.5.A person who knowingly and Intentionally falsifies the value•� .•'neferred
ote as
required bylaw,and Is prepared in.accor
real property,or omits or faisitt any information required to be provided,commits a Level 6 felony.
Sig ur of Sellpr Signature of Seller
if,Printed Name of Seiler Da (mm/dd/yyyy)
Printed Name of Seller I Date signed(mm/dd(yyyy}
Christopher A.Ramsey Director 2023
J. BUYER(S)IGRANTEE(S)—A . CATION FOR PROPERTYTAX DEDUCTIONS_IDENTIFY ALL THAT APPLY ..
Buyer 1-Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
•
James Reinhart Christine Johnson __—,
Address
(number and sheet) (number and street)�I� � ��,->a-,,n �1
2�q 5 r�na,n S `
City,state,and ZIP Code T ��
i City,state,and ZIP Code Y� 1�
Qountry
Country Irl
US
US
deductions:Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
0 0 3.Homestead
1,Will this property be the buyer's primary
O O residence? Q U 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 O b.Wind Power Device
ppC) - ' or this residence? If yes,provide address: 0 0 6.Hydroelectric Power Device
7\ O O 7.Geothermal Energy Heating or Cooling Device
Address(number and street)
City,state,Z,IP code,and county 1 0" *r- cam!��
+_r-�.Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of thy knoViiad98 aria 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
I
9, 7,,.,4-� transferred real property,or omits
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