HomeMy WebLinkAboutHomestead_Spindler (2)H. PREPARER
Preparer of the Sales Disclosure Form Title
Angela J. Moers Escrow Officer
Company E-mail address
Southwestern Indiana Land Title angie swinland.com
Address (number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN nited States of America 47713
1. SELLER(S)/GRANTOR(S)
Seller 1 Name as it appears on conveyance document
Keith G. Spindler
Address (number and street)
11117 S 200 W
City, State and ZIP Code
Haubstadt, IN 47639
Country
fA
Telephone number
(812) 425-0055
Seller 2 Name as it appears on conveyance document
Cheryl L. Spindler
Address (number and street)
11117 S 200 W
City, State and ZIP Code
Haubstadt, IN 47639
Country
nited States of America
nited States o menca
Tale hone Number Email Address felephone Number
Email Address sip y��
6J?-C31F-17 &L
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. n
r.i it Signat F e Salle°
Printed Name of Seller
Keith G. Spindler
Date Sig
J. BUYER(S)/GRANTEE(S) APPLICATION FOR PROP
Buyer 1 Name as it appears on conveyance document
Kevin A. Spindler
Address (number and street)
11087 S 200 W
City, State and ZIP Code
Haubstadt, IN 47639
ICountry
nited States of America
Printed Name f Seller
Cheryl L. Spindler
TAX DEDUCTIONS IDENTIFY ALL THAT APPLY
Buyer 2 Name as it appears on co�velya�cepc
Jennifer M. Spindler -� Tl
Address (number and street)
11087 S 200 W fl r r
City, State and ZIP Code i
Haubstadt, IN 47639
Country
nited States of America GIBSnni,,..�
0
Email Address Telephone Number I Email Address
(812) 779-6332 I (812) '
Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify ail of those that apply:
YES NO CONDITION
Q ❑ 1. Will this property be the buyers primary residence?
❑ Q 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
Q ❑ 3. Homestead
❑ Q 4. Solar Energy Heating or Cooling System
❑ Q 5. Wind Power Device
❑ Q 6. Hydroelectric Power Device
❑ Q 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 reDr al
property, or omits or falsifies any information required to be provided, commit a Level 5 felony.
D r r r dD d d.s
Signature of Buyer 1C�`
Printed Legal Name of Buyer 1 Sign Date
Kevin A. Spindler l D�
Last 5 Digits of Buyer 1 SSN/Driver s Lice nse/iD/Other Number
SSN N 7 73(Q s773 7
Siqnature of B
Br�dLeg NamedfBuyef2/Spouse Sign
Jennifer M. Spindler
Last 5 Digits of
e'e' A I a
Page 3
SSN/Driver s License/ID/Other Number
1/R/ & : QSD'TF