HomeMy WebLinkAboutHomestead_Mossberger Y . .,
H. PREPARER
Preparer of the Sales Disclosure Form Title
Megan Boger Escrow Officer
Company • -
Address(number and street,city,state,country,and ZIP Code) •
7412 Eagle Crest Blvd 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
Estate go, f Dale L. Crossfield
eld FILED
Address(number and street) Address(number and street)
City,state,and ZIP Code City,State,and ZIP Code APR 2 0 2022
/VISACirri/Ci - ole S/3„_S�v
Country Country ��
US US �a. ,f�i.»4/
the best of my knowledge and belief,Is true,correct and complete as
required by law,and Is prepared In accordance with IC 6-1.1-5.6.A person who knowingly and Intentionally falsities the value of transferred
real property,or omits or fal les any atlon required to be provided,commits a Level 6 felony.
Signature o er ,- Signature of Seller
Printed Name of Seller Date signed(rpm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Leslie W.Crossfeld Personal Representative o ti /1/ 7.3 2. ._.._
J. BUYERS)/GRANTEE(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 conveyance document
Christopher D.Mossberger -
Address(number and street) Address(number and street)
508 E Elm St Apt B
City,state,and ZIP Code City,state,and ZIP Code
Haubstadt,IN 47639
^Country Country
US US .
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1.Wtli this property be the buyer's primary 0 0 3.Homestead
O 0 residence? 0 O 4.Solar Energy Heating or Cooling System
Does the buyer have a homestead to be vacated 0 O 6.Wind Power Device
0 for this residence?IF yes,provide address: p p 6. Hydroelectric Power Device
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county • --?3_0/'9 -.PSO_co- 87 - o0 y
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Foreman Watson Land Title, LLC
C opy
7412EagleCrestBlvd
Evansville, ►N 47715
,