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Homestead_Mosley (2)
H. PREPARER . . Preparer of the Sates Disclosure Form Title Amanda Daly Settlement Agent Company Address(number and street.city.slate,country,and ZIP Code) 7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715 I SELLER(S)/GRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document Kyle Dougan Diane S.Hoffman Address(number and street) Address(number and street) 12422E 100 S 12422E 100 S City,state,and ZIP Code City,state,and ZIP Code Oakland City,IN 47660 Oakland City,IN 47660 Country CountryUS US 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. Si lu of Seller, • /9 � 15 z Date signed(mm/ddfyyyy) sr/ N. e of S,Iler I Date signed(mm/dd/yyyy) , Printed Name of Seller 01/31/2022 Diane S.Hoffman 01/31/2022 yle Do.�an . J. BUYER(S)IGRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on TILE D Tracey Mosley 1H Address(number and street) Address(number and street) 7222 Newman Road FEB V 7 2022 City.state,and ZiP Code City.state.and ZIP Code �,, L _- Elberfeld,IN 47613 /,ramJ Country Country GIBSON COUNTY AUDITOR US Tele a number ! �{ ( - - for certain deductions.Identify all of those that apply: Pursuant to IC 8-1,1-12-44,the Sales Disclosure Form may be used to apply YES NO CONDITION YES NO CONDITION ® © 1.Will this property be the buyer's primary (Al 0 3.Homestead residence? 0 ® 4.Solar Energy Heating or Cooling System 2.Does the buyer have a homestead to be vacated 0 (Al 5.Wind Power Device 0 r this residence? If yes,provide address: 0 IN 6.Hydroelectric Power Device Address(number and street) Q El 7.Geothermal Energy Heating or Cooling Device City,state.and ZIP Code County r)':3 Q _V/0—• d 06 Under penalties of perjury.I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete 3 ' -ON-4 „I 0 ° Face' )'N `�pF� GG JN.�� .\�soN