HomeMy WebLinkAboutMortgage_Retana (2) a' STATEMENT OF MORTGAGEOR CONTRACT INDEBTEDNESS County I Township Year
0 t FOR DEDUCTION FROM ASSESSED VALUATION
State Prescribed 4by Department 4) Gibson O a City 01
,,,, Prescribed by Department of Local Government Finance i- J
INSTRUCTIONS: File Mark
To be filed in person or by mail. - i se s-.I i...1
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. Or -1- -: •rder
2) Mobile/Manufactured Homes not assessed as Real Property Must file with the CountyAuditor of the county :7 r ��i!'1Y1/.
where the property is located during the twelve(12)months before March 31 of each year the deduction is 8'fB18O N. N Y AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner a contract buyer-see restrictions on reverse side)
Cynthia C. Blough-Retana
Taxing District Key number/legal description Record number Page m
Gibson 26-14-18-104-001.549-007 Up!�� 1 55 l l -7
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 aoolication legal or equitable owner?
96,800.00 92,541.00 Q 7 917 b3 p Yes ❑ No
If no,what 6 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, Inc.
Address of mortgagee or contract seller(number and sheet.city,state,and ZIP code)
7144 E. Virginia Street Suite 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 If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county , property for
in Indiana? Yes ❑No current year? ❑Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity tine of aedit that is recorded in the county recorder's office)that is the basis for the deduction.
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 bbe and correct and that the applicant is a resident of Indiana and
owne contract buyer of the aforementioned property on date application is filed.
-gal.atrL`_.1 j/ - 1g / Date(mignon.day.
/23/2015
ull resident a•dress of applicant(number and str-R.city,state,and and ZIP code)
135 W. Cherry Street, Oakland City, IN 47660
Person authorized by duty executed 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)
r
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S10,000.