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HomeMy WebLinkAboutHomestead_Mosser H. PREPARER Preparer of the Sales Disclosure Form Title 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 cJ e Barton L. Wagner Jaclyn M. Wagner Address (number and street) Address (number and street) 1806 Outer Lake Road 1806 Outer Lake Road NOV 3 2025 City, State, and ZIP Code City, State, and ZIP Code Princeton, IN 47670 Princeton, IN 47670 �1� � ,��,�� � Country Country / ,d� �'nd1 • USA USA GIBBON COUNTY QUDJTp Under penalties of perjury, I hereby certify 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. S,ture of Seller. SiaTlrre of Seller (.1r„.----....,.. LA...../e-pl /71 Z./LA7 .1' Printed Name of.„Stifel7 Date Signed (mm/dd/yyyy) Pred Na a of Seller ' Date Signed (mm/ddfyyyy) Barton L Wagner November 10, 2025 Jaclyn M. Wagner November 10, 2025 J. BUYER(S)/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 Chase Matthew Mosser Kiana Lee Mosser Address (number and street) Address (number and street) 703 East Strain Street 703 East Strain Street City, State, and ZIP Code City, State, and ZIP Code Fort Branch, IN 47648 Fort Branch, IN 47648 • Country Country USA USA YES NO CONDITION YES NO CONDITION 1. Will this property be the buyer's primary)g-. n El3. Homestead residence? n n 4. Solar Energy Heating or Cooling System - 2. Does the buyer have a homestead to be vacated ❑ E 5. Wind Power Device for this residence? If yes, provide address: n n 6. Hydroelectric Power Device Address (number and street) 0 []X 7. Geothermal Energy Heating or Cooling Device City, State, ZIP code, and County - 0(1,1c1 .19--10z- ocio . 0$ o -02_,(0 . 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 • Page 3 f.y. to- g