HomeMy WebLinkAboutMortgage_Clevenger e9l STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County 4� I
ms" FOR DEDUCTION FROM ASSESSED VALUATION �y
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Arta State Form 43709(R11 16-09) Gibson Ely
State
Prescribed by Department of Local Government Finance ���1.��.JJJ 111..///
File
INSTRUCTIONS: 11 n I
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
Must be filed with the County Auditor or County Recorder of the county where the property is located / aunty 1 dit
cap• o
on or before January 5 of the immediately succeeding calendar year. �• ' ^AIL•.r
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the '.113 • COU • •R
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.
Applicant(owner or contract buyer-see restrictions on reverse side)
Ryan C.(Cleveng0
Taring District Key number l legal description Record number Page number
Gibson '26=1 18=24-204:000.64 do/t/- /99?
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?
62,500 54,081 IS Yes ❑ No
If no,what is his/her exact share of interest? It 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
Motile 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 Street, Ste A. Evansville, IN 47715
•
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,slate,and ZIP code)
Does applicant own property in any other If yes,what county? What Taxing Disthct? 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 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.
�ignatu gY4 riarro/ Date(month,day,/13/)
. / G//�//j(,,r 05/13/2014
Fu es a address of applicant(n ber and street,city,state,and ZIP code)
1005 1/2 S Center Street rt Branch,IN 47648
Person authorized by duly ewe led Power of Attomey 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)