HomeMy WebLinkAboutMortgage_Toth STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
Ee FOR DEDUCTION FROM ASSESSED VALUATION
\ / Pretscribed by D partment�of9Local Government Finance F I
g LE
INSTRUCTIONS:
To be filed in person or by mail. Form filed with: n O,)
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. M A 17f1 0_
Must be filed with the County Auditor or County Recorder of the county where the property is located LLJJ ounty Auditor
on or before January 5 of the immediately succeeding calendar year. nt :-corder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the I . _„ -.i
county where the property is located during the twelve(12)months before March 31 of each ye r the
deduction is sought. GIBSON COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see rest.
CHRISTINE M TOTH - -
Taxing District ' Key number/legal description Record number Page niglbltr W1e9t
GIBSON 26-19-19-103-000.026-026 LOWES ADD 9 PT/10 PT AND 5 NW 19-3-10 201300002.79
Amassed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
March 1,anent year March 1.current year date of application legal or equitable owner?
85600 74400 74400 Q Yes 0-110
If no.what is his I her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant.indicate below Is the property in question:Annually Assessed
0 Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
LEGENCE BANK
Address of mortgagee or contract seller(number and street.city,sate,and ZIP code)
7325 E VIRGINIA ST, EVANSVILLE,IN 47715
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any other If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑
Yes 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 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.
Si�gnnatye,(owner's full name)) Date(month,day,year)
r\ \:1--.--1/24\r‘A 1-40 1 Y�1 i._, )( AA - 1).10—cacz_-1
Full resident address of applicant(number and street,city,sttale..and ZIP code)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 - Date(month.day.year)
Address of authorized person (number and street.city,state,and ZIP code)