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HomeMy WebLinkAboutMortgage_McCullough ."." o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I_ Township I Year (t/\e ? FOR DEDUCTION FROM ASSESSED VALUATION T 2't li Prescribed by Departmenttof Local Government Finance I°j ', rt�- INSTRUCTIONS: SUN 4 A File 201Mark To be filed in person or by mail with the CountyAuditor of the county where the property is located. Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. 2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)mo beforeparch�I offeeach year the deduction is sought. pvy7 `— See reverse side for additional instructions and qualifications. SON CO`UNYYAUDITOR Applicant(owner or contract buyer-see restrictions on reverse side) Jeffrey W.McCullough and Tara M.McCullough Taxing District Key number/legal description I Record number Pagg IMS`thPtnaPnt Patoka 26-12-29400-001.523-027/Pt of the SW Qtr.of the SE Qtr.of Sec.29, 20130000330 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 March 1,current year date of application legal or equitable owner? $165,306.00 © Yes ❑ No 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 ©Real Property ❑Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Mortgage Masters of Indiana Address of mortgagee or contract seller(number and street,city.state.and ZIP code) 7144 E.Virginia St.Ste.A 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 It 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 1 20 20 1 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 fortementioneldYproperty on date eapapplication is filed. �71{�oI( �I r(�� Si)na e(We lr nµ1K' �O)�C.J tl '�....fmC.CaX.lvirA � DaJuittri a re2rVt3 ✓ K U u ri,! nt address of appli nt(number and street,city,state,and ZIP code) 116 E.350 S Princeton, IN 47670 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)