HomeMy WebLinkAboutMortgage_Masters (4)�,• �•.a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Townshi Year
��"'�' FOR DEDUCTION FROM ASSESSED VALUATION �
1'��,'.:�- �°
,S�' .��. State form 43709 (R71 I6-09) 2012
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'�?'i Prescribed by Department of Local Govemment Finance � File Mark
�e�.
INSTRUCTIONS: DEC 4 2pip
To be Illed in person or by mail.
Filing Da(es: 7) Real Properiy: Musf be compleretl and datetl in the calendar year tor which fhe tl��, ht.
Musf be filed with the County Auditor or County Recorder o7 [he county where the property �s a e
on or 6e(ore January 5 of the immediately succeeding calendar year. c
2J Mobile / Manutactured Homes no( assessed as Real P�operty: Must (ile wim ��e�@biiRQ�Otfiqr,q(f OR
county wM1ere the property is Ixafed dunng the IweNe (12) months before March 31 07 each year the
deducfion is soughl.
See reverse side for additional instructions and qualifications.
Appliwnt (ownero�contrac7 buye�- see resMc7ions on �everse side)
Richard L. Masters and Brenda K. Masters
Taxing District Key number / legal descnption 26-OS-40-21 1-000.191-027 / Property
���� �
ssessed value of real property as of
larch 7, current year
no. what is his / her e.act share of inn
name on recortl i5 tliHerent Ihan Ihat (
W 225 N Princeton, Indiana 47670
i5_4�_2, , _0��., 9, -�2�
Motlgage / Contract Indebtedness unpaid as
Ma¢h 7, wrrent year
5124,900.00
of motlgagee or CoMract seller
Third Mortgage Company
ss o( mortgagee or contract Seller (num6er and sireet. cirv. siate. and ZIP cotlel.
Kingsley Drive. MD#1MOC BQ, Cincinnati, OH 45263
of assignee or other owner or holder of mortgage
ppbcant own pmperty in any otber I lt yes.
in Indiana?
�
approved in the amoun� oC
2� � 2�
Form flted with:
a�ounty Audilor
� County Recorder
tecortl number Page number
ao I� C�1��
7age / Contraa indebtedness unpaid as of Is the applicant the sole
of application legal or equita6le owner?
I�Yes ❑ No
someone other than spouse.
property in question: Annually Assessed
�al Property ❑ Annually Assessed
Mobile Home UC 6-1.7-
D' l `' �S � —
'�o. !1-��p
Car� jYp ... �%
20 _
�ested on property
� Yes ❑ No
20 20 20
Date (month, day, yeaQ
I/ We certify under penalty of perjury that the above and foregoing information is irue and correct and that the applicant is a resident of Indfana and
owner I contraci buyer of ihe aforementioned property on date application is filed.
i-gna/tur/e1ow/ne��/e� //(ulJ�/ar� e) � ate (month, day, year)
fY�s/, /Y�s % � i // —�J �- /-f
st�eef, c�ty, state, and ZIP code)
W 225 N, Princelon, IN 47670
or
person
(month, day, yeaQ