Homestead_Moser H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
Company
Address (number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document Seller 2 — Name as it appears on conveyance document
Donald L. Moser, Jr. Jolynn Moser
Address (number and street) Address (number and street)
411 W Oak St. 411 W Oak St.
City, State and ZIP Code City, State and ZIP Code
Oakland City, IN 47660 Oakland City, IN 47660
Country Country
United States of America United States of America
Email Address
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 . -ifies any information required to be provided, commits a Level 5 felony.
It-Sign. of Seller � '-----7
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"Minted Name of Seller Date Signed (mm/dd/ P A. ted Name of Seller Date Signed (mm/dd/yyyy)
Donald L. Moser, Jr. YYYY) olynn Moser 9/5/2025
9/3/2025
--"t ir
J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT Y 1
Buyer 1 — Name as it appears on conveyance document Buyer 2 — Name as it appears o4 n ebnent
Jolynn Moser Jeremy Newton
Address (number and street) Address (number and streetik/D ,
411 W. Oak St 12269 E100 S y 2025
City, State and ZIP Code City, State and ZIP - e
Oakland City, IN 47660 Oakland City, IN ( SAj
Country Country C,pON `�
United States of America United States of America �Ygvol�
OR
Email Address
for certain deductions. Identify all of those that apply: r r )
YES NO CONDITION YES NO CONDITION
21 D 1. Will this property be the buyer's primary residence? El 0 3. Homestead
Cl El 2. Does the buyer have a homestead to be vacated for ❑ 0 4. Solar Energy Heating or Cooling System
this residence? If yes, provide address: 0 El 5. Wind Power Device
Address (number and street) ❑ El 6. Hydroelectric Power Device
❑ El 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
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