Mortgage_Byrns (8) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year
& FOR DEDUCTION FROM ASSESSED VALUATION
� Sate Fwd by De (Rment of FILED
• �T:/ Prescribed by Department of Local Goverrurient Finance
INSTRUCTIONS:
To be filed in person or by mail. Form files with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. M V Mf 2 county Audilor
Must be filed with the County Auditor or County Recorder of the county where the property is located V�
on or before January 5 of the immediately succeeding calendar year. ❑ County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the
county where the property is located during the Mehra(12)months before March 31 of each year the
deduction is sought. GIBSON COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Aaron D. Byms
Taxing District Key number/legal description Record number PageT (UO1BOt
Montgomery Township 26-17-04-400-000.817-021 /Part Lots 23-24 Johnson's 1st Add. 2013000024(6
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1,current year March 1,current year date of application legal or equitable owner?
$45,900.00 $77,077.00 0 Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse.indicate with whom
n/a Na
If name on record is different than that of applicant.indicate below: - Is the property in question:Annually Assessed
Na GI 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,and ZIP code)
501 Cross Pointe Blvd., Evansville, IN 47715
Name of assignee or other owner or holder of mortgage
n/a
Address of assignee(number and street city,state,and ZIP code)
Na
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 gNo ❑ 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/contract buyer of the aforementioned property on date application is filed.
Signature(owner's full name) Date(month.day,year)
G 1 p 04/30/2013
Full resident address of applicant(number and street, ,state.and ZIP code)
5126 S.980 W.,Owensville,IN 47665
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)