Homestead_Adler (10) H. PREPARER
Preparer of the Sales Disclosure Form Title
Milton Norman Settlement Agent
Company
Address (number and street, city, state, country, and ZIP Code)
25 NW Riverside Drive, Suite 310, Evansville, IN 47708
I. SELLERS)/GRANTORS)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on conveya . e
Eugene N. Reibel Trust dated July 20, 2009, as amended
1(.. .46 )
Address (number and street) Address (number and street) //��
2421 W 1025 S Deil
City, State, and ZIP Code City, State, and ZIP Code v*
Fort Branch, IN 47648 Q� iim ?O�?,+ t
Country Country p41 ` co
US c i
o
// �-16 )
Under penalties of perjury, I hereby ce ify this Sales Disclosure, to the best of myknowledgeand belief, is true, co • .�41/ • d complete as
� R ,.
required by law, a d is preps d in a ordance with IC 6-1.1-5.5. A person who knowingly and intentionally falsifies the alue of transferred is
real property, or riL,,tor fa ' ies y information required to be provided, commits a Level 5 felony. _(.
Signature er1 Signature of Seller
Printed Name of Seller Date Signed (rnmidd/yyyy) Pnnted Name of Seller , Date Signed (mrn/ddtyyyy)
Eugene N. Reibel, Trustee /'? /1/2 ,
J. BUYER(SWGRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL THAT APPLY I
Buyer 1 - Name as it appears on conveyance document Buyer 2 - Name as it appears on conveyance document
Joshua D. Adler _ Shy.a M. Adler _
Address (number and street) Address (number and street)
1412 West Chukar Hollow Road 1412 West Chukar Hollow Road
, F
City, State, and ZIP Code City, State, and ZIP Code -- ;..'
Haubstadt, IN 47639 Haubstadt, IN 47639 i
Country Country
YES NO CONDITION YES NO CONDITION
.v 1. Will this property be the buyer's primary 3. Homestead 1
(~1 ® O residence? 0 ® 4. Solar Energy Heating or Cooling System •
0 0 2. Does the buyer nave a homestead to be vacated C ® 5. Wind Power Device
®
0 for this residence? If yes, provide address: 0 2 6. Hydroelectric Power Device
O Address (number and street) , 0 ® 7. Geothermal Energy Heating or Cooling Device
Q r 41 , Kt (-1,1.� k r jlr/(c:�j
r ) City, State, and ZIP Code County
1
I n,t., Es 4 n.c 4 i'n1 L{ 1 lv 3 3 I S D 1�' `- 3 y C�U 2- 2-9 3 �Zy .
M Under penalties of penury, 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
I
Page 3
-c./.)\