Mortgage_Sutt e " STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township ( Year
gig! ) FOR DEDUCTION FROM ASSESSED 1t+, ry'N�D
•
S• State Form 43709(R11/6-09)
� � Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: MAY 9 2013
To be filed in person or by mail. Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. �Counry Auditor
Must be filed with the County Auditor or County Recorder.J e cpun1 w - •• : .perty is located
on or before January 5 of the immediately succeeding ca -h,�;y + =/�rl�j� ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as '.. _'..�- 14 It .14 q(ipty Auditor of the
county where the property is located during the twe e( )«T6ht 3415 each year the
deduction is sought
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Whitney Layne Sutt
Taring District Key number/legal description Record number Page ItneeFU01?n
Oakland City 26-14-18-102-000.589-007/Lot 13 Marion Heights Addition 2013000024SO
Assessed vahm 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 March 1,current year date of Tpph lion legal or equitable owner?
$90,600.00 $ O�c))�(O_ r GI Yes ❑ No_
If no.what is his/her exact share of interest? If owned with someone offer 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
rile 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,and 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,city,state,and ZIP code)
•
n/a
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 anent year?
❑ yes No ❑ yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature o ty Auditor County _ Date(month,day,year)
V t�
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/contract buyer of the aforementioned property on date application is filed.
Signatur-(o• n,rs tuft ame) Date(mortcPay, ar
numb rM y / (.� / �/2013
Full resident address of a•�.-.nt(number a sheet,city;state,and ZIP code) `
827 Highland Avenue,Oakland City, Indiana 47660
Person authorized by duty 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)