HomeMy WebLinkAboutMortgage_Barnes�•�;, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count I Township Year
E__ 4 FOR DEDUCTION FROM ASSESSED VALUATION
. ��%' State Fwm 43709 (R11 / 6-09) Gibson I HaubS�adl 2012
Z - Pr@SCnbeC by Departm@nt Of loWl GOVamment FnanCB
File Mark
�NSTRUCTIONS:
To be (!ed in person or by mail.
Filing Da/es: 7/ Real Property: Must be cwnpleted and dated in [he calendar }Rar fa which 1he deduUion is sough(.
Musf be filed wi�h fhe Counry Auditor or County Recorder o7 the county where 7he property is lowled
on or belore January 5 o7fhe immediafety sucteedirg calendar year.
2) Mobile /ManWacfured Homes not assessed as Real Property: Must !i!e with fhe County AuOitor ol (he
county where the pmperry is bcated dunng Ihe twelve (72J mon(hs before March 31 of each year the
deduclion is sought.
See �everse .vde /or addilional instrucfions and puali/ications.
Applicant (aM++er w wnt2c� ouyer - see restrrctions on reverse stle)
Joshua J Barnes
F de vith:
I C �❑ County Recor er
C. �.lV1_--r?—
Tazirg DistriG Key number / legai deunplion Remrd number Page nurti62f' �
Haubstadi 2fr19-31301-000.360-009 ls 149, 150 & 151 Org Plai Twn of Haubstadt � Q y�
Assessed value of real property as of Mortgage / Contracc intlebtedness unpaitl as of M1lorigage / Cmtract indebtedriess unpaid as W Is me apqkant Ne sde
�March 1. wrtentyear Mar� 1, airtenl year date of applio4on legal or eQ�nlaWe wme(?
S74800.00 5103510.00 Q Yes ❑ No
If no, what is his I her ezact share of interest? . If awnetl wiN someone other lhan spouse, "vMimte wiN whom
If name rn recwd is Ei°erent than Iha� W app6canl. indicate bebw_ Is the property in question: Mnwlry Assessed
❑� Real Propefty ❑ MnuaRy Assessed
John R Goddard a.�„nne u,.,.,e nr �� �_;
Name of mwtgagee a conua<t 5e0er
MSI Mortgage Services III, LLC
ddress ol rtwrtgagee or mntratl seller (numberand street uty, state. and ZIP cotle)
502 N Hershey Rd, Bbomingion, IL 61704
Name of assgnae or other owner w holder of mortgage
AEdress of assignee (number and sneet afy. sfafe, and LPcade)
appticant w.�n O�Perty in any oiher
y in Indiata?
❑ Yes
No
I/ ye5.
NTat
artEni
rn GmGenY
4[7
COUNN AUDITOR
Detluction approve0 in the amount of:
20 20 20 20 20 20 _ 20
Signawre W GwntyAUditw Couniy Date (monN, tlay, yaar)
1 I We certify under lhe penalry of perjury lhat the above and toregoing intortnauon is true and correa and that the applicant is a resident ot Indiana and
owner / contrea buyer of the a(orementlonetl property on date application is filed.
�SignaWra owners /Wl name) Date prronfi. day. yea�
(1x,,,,` os/3onot i
Full resiCent atldress of applicant (numDer antl sfree( city. slate, an0 LP code)
307 W Gibson 51, Haubstadt, IN 47639
Person auNOrizetl by duy e.ecuteG Power of Altomey w Dy IC Fil. t-12-0.7 6ate (monlh, tlay, yEa�
Address of authonied person (nvmDer an05iee1. dty. state. arid ZIP co0e)