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�I\DUNA SALES DISCLOSURE FOR�I SDF ID SDO ID 465059 Page Y
D.PREPARER
Crista Wallace Typist
Prepnrtrofthe5ales0ittlosureFOrm Tide
SOS S. E. Martin luther King Jr. Blvtl. Southwestem Indiana Land Title
Address (��'um6erand5veerJ lompan}'
Evansville, IN 47713-
E.SELLER S GRANTOR S � -
qarence D. Mossberger Teresa A. Mossberger
Seller }�.�'ame ar oppean om m�vnvnre doaumm� Se/!er I� h'ame vs appenrs on ron:qnnce drcumenc
10652 W 1000 S 70652 W 1000 5
Address (Numberand5vret) Addrecs (tium6erond SveeeJ
Poseyville, IN a7633- Poseyville. IN 47633-
Ciry.Srotc. and ZIV UCe CIry.Srotq md ZIPCOde
E-mail
Under penalties of perjury, 1 hereby certi(y that this Sales Disclosure, m the best of my knowledge and belie(, is true, correct
anjd mmplete as require/d by law),� _an/d is prepared in ,a/ccordance with IC 6-i.1/-S.S� y"Real Proper/�ty�, Sale�s� Dpis�dosure A t".
i?IiN/.v�C'1�. �eSS6r�.j.m1'i'"I�'Z^'�.�rw%!'Lt��/� l�/�1Ctift-�f/1drS�=u`19'i�"Yf°nu'�ISa:�.�ii:G
Signacure o(Seller $qnaove o(Seller
Gl�r,e D. �`tssterger b,� &mly �dth, AIE�' 3/27�10 Tei.�sa A. Nt�ssUa�er b� Fir�ly �,n'ath, AIF' 3/22/10
. UYER S GRAN 5- APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
� � Vlctor R. Paul
Byrrl-Nameas - �rsonronrqvnredarumen: lJyer2-,VOmeusappearsanronvryvnredxumen[
8�7100 W
Addia (NumAerandSVaQ Addrua(Num6ervnd5neet)
Owensville, IN 47665-
�Ciry, Smfe, andLlP fode CiRt Swtr, andZ1Y Code
E�mail Tele honeSumber E-nail
THE SALFS DISClOSURE iORM NAY BE IISED TO APPLY' FOH CERTAIN DEDURIOYS FOR THIS PRO . . OF TNOSE THAT APPLY.
YES \O CONOITIOA YFS NO CO�DITION
X❑ � 1. Will this properry be the buyer's primary ❑x ❑ 3. Homestead
residence? Provide complete address of primary Q 4. Solar Ener eating/Coolin� Syscem
residence, including county: �
8297 S 1700 W 5. Wind Power Device
AJdrcss(A'urnberandSlrcet) ❑ Q 6. HydroelecVic Po�ver Device
Owensville, IN 47665 GIBSON � � 7. Geothermal Energy Heating/Cooling Device
Ciry, Smre Z1P CoAr Counry
�x ❑ 2. Does the buyer have a homestead in Indiana co be � � 8. Is this property a residential renwl properry?
vacated for [his residence? If yes, pro��de ❑ 0 9. Would you like to receive tax statements for [his
comple[e address of residence being vacated, property via e-mail? (Provide con[oct information
including county: below. Please see instructions for more infonnation.
5300 vWE ROAD Not avoila6le rn all counties.)
Address /A'um6erand5vicee]
Wadesville, IN a7638 POSEY (�� ��� aQ. �(fQ - ��Q. a49- �
Ciry.SmteZlPCadr Counry
Pnnoryproperry awner conma name E-mail
Under penalties of perjury, I hereby certify that this Sales Disdosure, [o the best of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (No[e:
Spouse information, Social Security and Driver's License/O[her numbers are not necessan� i(no Homestead Deduction is
be ng filed.
�lr�i �'. P��� f�S,�'.�t, A-r�
Signamrea/8uyerl �- Signomreo(BUVer2/Syouse
Victor R. Pail b,� Frm1y 3rdth, AIF 3/22/10
PnnndLegalA'ameo(Bvyert SignDa:e�uv/o�/YVrY7 Pdn:MLegalNameofBuyerd/Spouse SgnDa�e(N.4/DD/rrrr�
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so(SxialSecuriryNum6er LastSdigirso/Buyer2/SpouseDnveri Sm[e Las[SDigittojSOCialSecunry
Lirense/ID/OtherNumber M1'umber License/ID/OtherA'umber
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