HomeMy WebLinkAboutmortgage_Byrns (7) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year
a e FOR DEDUCTION FROM ASSESSED VALUATION
tietState Form 43709(Rit/6-09)
i,i Prescribed by Department of Local Government Finance �'?
INSTRUCTIONS: a lark�-y
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. �0gTT11
Must be filed with the County Auditor or County Recorder of the county where the property is located J 110 3,.1,uM)3 dimr
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 twelve(12)months before March 31 of each year the
deduction is sought.
See reverse side for additional instructions and qualifications. GIBSON COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
GRANT A. BYRNS and SONYA A.BYRNS
Taxing District Key number/legal description ReFOrciu�r P`a�OTJ
MONTGOMERY 26-17-24-200-004.830-021 ((�r''JJ�(1j Pi age
Assessed value of real property as of Mortgage I 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?
$ GI Yes ❑ uo
If no,wnat 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
12 Real Property ❑Annually Assessed
Mobie 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
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 propeny
county rn 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/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.
Sig a1u Q el r came) r / �S/ /Date(month.day,Y.,eaDrl!
/tl/ l/i !/��f Oa;G c 12013
Full resident addreKof as t(number and street,city,state,and ZIP code)
7499 S.State d 65,Owensville,Indiana 47665
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)