Homestead_Mendoza 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
person who knowingly and intentionally fa value of transferred
real property,or omits or falsifies any information required to he provided,commits a Level 5 felony.
Xture of S 2 - Signature of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Alp
jQ� Date si •d/yyyy)
Phillip Reinbrecht, President 4/19/2024
J. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY/e AT APPLY 474
O "
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears cal hi renspiance document
Daniel S. Mendoza Oi/ry1� r
Address(number and street) Address (number and street) AioO/T cs
103 E. Northview Dr. _ 0R
City, State and ZIP Code City, State and ZIP Code
Huntingburg, IN 47542
Country Country
United States of America
Email Address Address Telephone Number
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 X'
0 ❑ 1. Will this property be the buyer's primary residence? IZ 0 3. Homestead a .- ''"-,.
- _ ❑ 0 4. Solar Energy Heating or Cooling Syst
0 0 2. Does the buyer have a homestead to be vacated for 0 0 5. Wind Power Device
this residence? If yes, provide address: Rs
_. CIlO 6. Hydroelectric Power Device
Address(number and street) 0 11 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code, and county
cat-12-19 — I103-006 . CO) - oz8 .
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct and complete
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