HomeMy WebLinkAboutMortgage_Harrison (2) eyw STATEMENT OF MORTGAGE OR CONTRACT INDEBTED County Township Year
. R 4 FOR DEDUCTION FROM ASSESSED V AlItE
State Form 43709(R11/609)
"'. Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: o 213
To be filed in person or by mail. MAR 2.. Form flea wi
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduct!. is sought.
Must be filed with the County Auditor or County Recorder of the •unty w ire 4 • .perry is located County Auditor
on or before January 5 of the immediately succeeding calendar, ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property: • '^ �+• )ffOitor of the
county where the property is located during the twelve�ggCtb . arch 31 of each year the
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Trevor Scott Harrison and Brittany N. Harrison. Husband and Wife
Taxing District Key number/legal description Record number Page number
Columbia Civil Township 26-14-07-300-000.507-006/Pt NW SW 7-2-8 5 Acres 13-' /q 7S
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year Marco 1,current year date of application legal or equitable owner?
$88,000.00 $100,050.00 U Yes ❑ No
If no.what is his/her exact share of interest? If owned with someone other than spouse.indicate with whom
n/a n/a
If name on record is different than that of applicant.indicate below: Is the property in question:Annually Assessed
n/a O Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Kirkston Mortgage Lending, LLC
Address of mortgagee or contract seller(number and street,city,state,end ZIP code)
501 Cross Pointe Blvd., Evansville, Indiana 47715
Name of assignee or other owner or holder of mortgage
n/a
Address of assignee(number and street,cit(state,and ZIP code)
n/a
Does applicant own property in any otner If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑ yes S No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month.day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
Signature(owners hull name) Date(month.day,year)
Full resident address of applicant(number and street,city,state,and ZIP code)
250 S. 1150 E.,Oakland City,Indiana 47660 Q
Person authorized by duty executed Power of Attorney or by IIIC�'.1-12-0.7 ��'vy )/ to(month,day,year)
Christopher E.Cad,Attorney in Fact Ca ( � A,r— -Sir Raz .A7 7�. _Sj 03/08/2013
Address of authorized person (number and street,city. e,and ZIP code) Y
True Title Service,LLC,101 Plaza East Blvd., Suite 102,Evansville, Indiana 47715