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HomeMy WebLinkAboutHomestead_Pezeln. rRGr1AMr_M Preparer of the Sales Disclosure Form Matthew Jarvis Title Escrow Officer Company E-mail address Southwestern Indiana Land Title matt@swiniand.com Address (number and street, city, state, country, and ZIP code) 605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713 JCLLCMJ0JiUKAN I UK(S) Seller 1 — Name as it appears on conveyance document Elite Companies, Inc., an Indiana Corporation Address (number and street) 304 E SR 68 City, State and ZIP Code Haubstadt, IN 47639 Country United States of America Email Address Telephone Number dona@reinbrechthomes.com Telephone number (812) 425-0055 Seller 2 — Name as it appears on conveyance document Address (number and street) City, State and ZIP Code Country Email Address Telephone Number Under penalties of perjury, I hereby certify 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 transferred real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. Signature of Seller ^� Printed Name of Seller Date Signed (mm/dd/ Phillip Reinbrecht, President yyyy) 5/4/2026 Signature of Seller Printed Name of J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS —IDENTIFY ALL THAT APPLY Buyer 1 — Name as it appears on conveyance document Skylar Pezel Address (number and street) 6135 Alexandria Dr, Apt D City, State and ZIP Code Evansville, IN 47715 Country United States of America Email Address Buyer 2 — Name as it appears Address (number and street) City, State and ZIP Code Country G/GSON Telephone Number I Email Address (219) 781-8909 Date Signed (mm/dd/yyyy) v y ce document t> At bbne 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 anoiv: YES NO Z ❑ CONDITION 1. Will this property be the buyer's primary residence? 2. Does the buyer have a homestead to be vacated for this residence? If yes, provide address: Address (number and street) City, State, and ZIP Code County YES NO CONDITION Z ❑ 3. Homestead ❑ Z 4. Solar Energy Heating or Cooling System ❑ Z 5. Wind Power Device ❑ Z 6. Hydroelectric Power Device ❑ Z 7. Geothermal Energy Heating or Cooling Device 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 transferred real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note: Both spouse's information, SSN/Drivers License/ID/Other Number is necessary if a Homestead Deduction is being riled.) ign ture of Buyer 1 Signature of Buyer 2/Spouse Prin eat Leg Name of Buyer 1 Sign Date (MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY) Skylar Pez 5/4/2026 Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number °SSN: C �i IN 01 ; 72 ,8674 Page 3