Homestead_Carroll H. PREPARER
Preparer of the Sales Disclosure Form T tle
Abbey Moore Closing Agent
Company
Address (number and street, city, state, country, and ZIP Code)
4905 Theater Drive, 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
Harry P. Sausser III Samantha A. Sausser
Address (number and street) Address (number and street)
21434 Kentucky 811 21434 Kentucky 811
City, State, and ZIP Code City, State, and ZIP Code
Reed, KY 42451 l Reed, KY 42451
Country Country
USA USA
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 a Si‘ .9.0al,uPe of Seller
P ' ame of Seller Date Signed(mrnrdd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy)
Harry P. Sausser, III October 3, 2025 Samantha A. Sausser October 3, 2025
J. BUYER(S)/GRANTEE(S) -- APPUCATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY
Buyer 1 - Name as it appears on conveyance document Buyer 2-Name as it appears on co e document
Koal Carroll
Address (number and street) Address (number and street)
426 North Lincoln Street -Ltb
City, State. and ZIP Code City, State, and ZIP Code O
Oakland City, IN 47660 Cl 0 _�
Country Country 9 �Q?S
USA l
OTCn, Q.
Pursuant to IC 6-1.1-12-44. the Sales Disclosure Form may be used to apply for certain deductions. Identify Auto t at apply:
YES NO CONDITION YES NO CONDITION Z/piro '
1. Will this property be the buyer's primary l El 3. Homestead
a ❑ residence? ❑ 0 4. Solar Energy Heating or Cooling System
L1 2. Does the buyer have a homestead to be vacated ❑ 5. Wind Power Device
❑ U for this residence? If yes, provide address: ❑ n 6. Hydroelectric Power Device
Address (number and street) ❑ n 7. Geothermal Energy Heating or Cooling Device
City, State, ZIP code, and County
1 � - I8 -ya l - 0 0 0 -oU
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 property, or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note: Both spouse's
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