HomeMy WebLinkAboutMortgage_Retana Ara STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
(,______" `� FOR DEDUCTION FROM ASSESSED VALUATION
• State Form 43709(R71/6-09) GI Oakland Ci 2015
- Prescribed by Department of Local Government Finance �`-'y�1 �
INSTRUCTIONS:
b H Fiery-
To be filed in person or by mail. I Form fled with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. AIR 1 hZO!4
Must be filed with the County Auditor or County Recorder of the county where the property is located Bounty Auditor
on or before January 5 of the immediately succeeding calendar year. ❑ ount 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. GIBSON COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Cynthia C Blough-Retana
if District Key number/legal description I Record number Page nump r
` .xlOWY\ 26-14-18-104-001.549-007 U` 1{1 ^^••//���
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applican thesis
March 1.current year March 1.current year date of application legal or equitable owner?
96,800.00 84,000.00 96,153.00 ri Yes ❑ No
If no.what is his/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
0 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 Avenue, Evansville, IN 47715
IName of assignee or other owner or holder of mortgage
IAddress of assignee(number and street,city.stare,and ZIP code)
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 0 No I7 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 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.
at 1 hers Iheme Date(month,day,ye )
Full resident address of applica (anger aA:street.city,state,and ZIP code)
135 W Cherry Street,Oakland City, IN 47660
Person authorized by duly executed Power of Attorney or by IC 611.1-12-0.7 I Date(month,day,year)
Address of authorized person (number and street.city,state,and ZIP code)