HomeMy WebLinkAboutMortgage_Carr (3)sy.=•�A STATEMENT OF MORTGAGE OR CONTi2ACT INDEBTEDNESS
.�'�i FOR DEDUCTION FROM ASSESSED VALUATION
•�' Sate Form 43709 (R77 / 6-09)
"�' Prexribed by Department of Local ;�ovemmen� Finance
Tr�+,,�p,-tlx.� L.n.d T�-Ne_,�a.
Gibson
INSTRUCTIONS: � -
To be �led in person or by mail.
Filinq Dates: 1J Real Pmperty: Must be completed and dated in fhe calendar year fo� which tbe deduction is sought.
Must be fifed with lhe County Audifor or County Recorder o/ the county where the property is located
on or 6e�ore January 5 of the immedia[ety succeeding calendai year.
2J Mobile / Manulactured Homes not assessed as Real Property: Mus[ file with the CountyAudito� 07 the
county wheie the propeRy is located dunng fhe tvielve (12/ months before March 37 of each year the
deduction is sought �
Oakland Ci[y 2013
, File rij
rortn tleC with:
�' p� Z�nry Audi.or
❑ Counry Recorder
See reverse side 7or additional instructiuns and qualifications. GIBSON GOUN i r Huui i vn
Appican� (owner w contracl buyer - see restrictions on reverse side)
Noah R. Cart
Tadrg Disirict Kay numbeN legal descnOtion Record num5er Page number
Gibson z�-,4-,�-zo,-oo,.o��o� ao�a 55y
Assessed value of real poperty as W Mortgage / ConVaci indebtedness unpaid as of Mort9age / ConVact intlebtetlness unpaiC as of Is Ihe applicant Ne sde
Marc3� 7, anent year March 1, cunent year Cate of application legal ar equRable rnvner?
69,400.00 60,000.00 93,877.00 ❑� Yes ❑ No
If rro, wnat is his / her exacc shara of interest? If owned Mih someone oNer than spouse, intliwte wiN whom
If name on recortl is tli9erent Man Nat of applinnt, indicate beMxc Is the property in question: Mnually Pssessed
❑� Reai Property Q MnuallyPsxssed
Mobile Home (IC Cr1.1-7)
Name of mort9a9ee or conVact se0er
Mortgage Masters of Indiana, Inc.
Pdtlress of mortgagee or contract se�er (number end sVeeG riry. sate. end ZIP wde)
7144 E. Virginia Street Suite A, Evansville, IN 47715
Name of assi9nee w oNer owner or hdder of mortgage
Atltlress of assignee (numberand sfreef, rity, sfate. antl ZIP code)
Daes applirant own pmperty in any other If yes. �ehat munry? What Ta�dng District? Has Nis tleCUCtion bxen requested on pmperty
county in Indiana? � Ye5 Q NO for cunent year? O Ye5 ❑ No
� COUNTYAUDROR
DeCUCtlon approvetl in the amount o`:
20 _ 20 20 _ 20 _ 20 20 20
Signawre of CounryAUdew Coun.y Date (month, Gay, year)
I I We certify under the penalty ot perjury that the above and foregoing informalion is we and wrrect and that ihe applicant is a resident oi Indiana and
owner / conVact buyer of the aforementloned property on date application is �led.
Sign re (owne/s fW name) • Date (monlh, day, yea�
�G� 9I28/2012
IPW resiEent address ot appticant (num0erand street, cdy, sta(e. antl ZlPCOtle)
222 E. 2nd SVeet, Oakland Ciry, IN 47660
( Person auNOrized by dNy ezecutetl Power o( Attwney or by IC G1.142-0J Da:e (monfh. day, year)
Address of au'.horized person (number and snceL dry, state, and ZIP code)
Y\
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