Homestead_Smith (31) 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. SELLERS)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on n ey c oc ent
Michael Helfert
Address (number and street) Address (number and street)
6610 Saint Wendel Cynthiana Road -1)
City, State, and ZIP Code City, State, and ZIP Code e
Poseyvillc, IN 47633 4 2D25
Country Country > •
USA
E-mail Address Telephone Number E-mail Address GlN C UCN n�" lephone one Number
michaelhelfert868@gmail.com (812) 306-8648 -
•
Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, co eiiand 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.
Signature Signature of Seller
Printed Name of Seller Date Signed (mrrr'ddiyyyy) Printed Name of Seller Date Signed (mm/dd/yyyy)
Michael Helfert November 24, 2025 I November 24, 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
Mason J. Smith Amber Feldpausch
Address (number and street) Address (number and street)
7999 South SR-165 7999 South SR-165
City, State, and ZIP Code City• State, and ZIP Code
Owensville, IN 47665 Owensville, IN 47665
Country Courtry
USA USA
CONDITION
��11 l L. 1 . Will this property be the buyer's primary n n 3. Homestead
I^1 .J residence? n 0 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated AN
n n
5. Wind Power Device w-_, .. 1
1 1 ` for this residence? If yes, provide address: n Q 6. Hydroelectric Power Device
Address (number and street) [1 7. Geothermal Energy Heating or Cooling Device
City, State, ZIP code, and County _ 1
�--- 19 — tee - COO .3L) 4 -oz)
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete
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