HomeMy WebLinkAboutHomestead_Moskos 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
Gary W. Moskos
Address (number and street) Address (number and street)
12771 S Sunset Dr.
City, State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639
Country Country
United States of America
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.
Sign re of Sel r45( Signature of Seller
(/1r
teclme of Seller Date Signed (mm/dd/ Printed Name of Seller Date Signed (mm/dd/yyyy)
Gary W. Moskos YYYY)
3/30/2026
1
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 a r o onveyance document
Tannor G. Moskos
Address (number and street) Address (number and street) '
2440 Old State Rd 65 .• a 1
City, State and ZIP Code City, State and ZIP Code -��'•►��•: C2,
Owensville, IN 47665 •
t Counry '
Country 2-c-Zei.- ' r-Y-c-- --)
G/
United States of America gSONon, Q
apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
❑ ❑ 1. Will this property be the buyer's primary residence? IR1 El 3. Homestead
❑ '� ❑ 0 4. Solar Energy Heating or Cooling system 2. Does the buyer have a homestead to be vacated for
this residence? If yes, provide address: ❑ IZJ 5. Wind Power Device
sol❑ RI 6. Hydroelectric Power Device ,.. _-ti'
Address (number and street)
❑ 0 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
DL Q- a - i LA - h-- no 1 . -- O .
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 information, SSN/Driver's
License/ID/Other Number is necessary if a Homestead Deduction is being filed.)