Homestead_Klusmeier M. PREPARER - - - ----- ---- -
Preparer of the Sales Disclosure Form Title
Katie Felty Escrow Officer
Company
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document i Seller 2 - Name as appears on conveyance document
Coy W. Green Tricia B. Green
Addres (n mb- s er andet) Address (number god skeet)
- � t , YA ,
, 5 Al 1/4-A-'ti----.
I City, s te, and Z'P Code City, stale, and ZIP Code
1
0S a- --t
Country Country
US US
required by law, and Is prepared in accordance with IC 6-1.1.5.6. 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 6 felony.
Signature of Seller Si ature of Seller
__,:70,..-• 4.11 % SAS:2111
Printed Nene of Seller Date signed (mm/dcsyyyy) Pon ed Name of Seller ate mm/dd,signed g ( 'YYYY)
Coy W. Green 9/30/25 Tricia B. Green 3/ 1/25
,E) _
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIF LL
Buyer 1 -Name as it appears on conveyance document Buyer 2- Name as it appears on conveyance document -
Krista K. Klusmeier Chad D. Klusmeier Ge r
Address (number and street) Address (number end street) 1 [U25
309 Certain Street 309 Certain Street
City, state, and ZIP Code City, state, and ZIP Code c_f
Owensville, IN 47665 Owensville, iN 47665 1 � >-e"-/ a. ,,,
.6;„,) .
____
Country Country Nil' AUDITOR
US US
D O 1. Will this property be the buyer's primary CI 3. Homestead
residence? O Q 4. Solar Energy Heating or Cooling System
O 2. Does the buyer have a homestead to be vacated O U 5. Wind Power Device
for this residence? If yes, provide address: 0 Q 6. Hydroelectric Power Device
Address (number and street) 0 O 7. Geothermal Energy Heating or Cooling Device
City, state, ZIP code, and county
6 — l LI -1g - 02_ - a00 5-91 -004 .
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 end intentionally falsifies the value of
!....
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