HomeMy WebLinkAboutMortgage_Carpenter (2) �• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ` County I Township Year
dt a Act\
FOR DEDUCTION FROM ASSESSED VALUATION
i,�S• State Form 43709(Fin/5-09) bs I Branch 2014
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'�'sr: Prescribed by Department of Local Government Finance
INSTRUCTIONS: jl/ Mack
To be filed in person or by mail. p�L(�,{1 Form fled with:
Filing Dates: 1) Real Properly:Must be completed and dated in the calendar year for which the deduction 4,4YNtif 7 201.
Must be filed with the County Auditor or County Recorder of the county where the property is located County Auditor
on or before January 5 of the immediately succeeding calendar year. II County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Au.,. of the I _vi
county where the property is located during the twelve(12)months before March 31 of ea • ).. aniirrn R.
deduction is sought. alg$ON COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer.see restrictions on reverse side)
Jonathan C.Carpenter
Taxing District Key number/legal description Record nu er Page number
Ft Branch 26-19-19-102-000.057-026 api 4110 30?
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Maras 1,current year March 1,current year date of application legal or equitable owner?
76,800 110,714 GI Yes ❑ No
If no,what is his/her exact share of interest? downed 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
Mortgage Masters of Indiana, Inc.
Address of mortgagee or contract seller(number and street city.state.and ZIP code)
7144 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 II yes,what county? What Taxing District? Has this deduction been requested on properly
county in Indiana? for current year?
❑ Yes 0 No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 I 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.
Sy re � �� t _is J Date(month,day,year)
8/23/2013
J resident address of applicant(number d street.city,state,and ZIP code)
302 S.Hill Crest St.Ft.Branch. I 47648
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)