HomeMy WebLinkAboutMortgage_Almon tit STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township I Year
;e-_: FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R12/6-14) Gib I I I'�
Prescribed by Department of Local Government Finance sp I� i�i
INSTRUCTIONS: 1111
To be filed in person or by maiL AUG 2 farm filed with:
Filing Dates: 1) Must be Property:ed completed
and
County Auditor or County which the deduction is
the county where the property is V U p .LI-`W inty Auditor
located on or before January 5 of the immediately succeeding calendar year. II C•unty Recorder
2) Mobile/Manufactured Homes not assessed as Real Property Must file with the County Auditor of the cou , •
where the property is located during the twelve(12)months before March 31 of each year the deduction is 41.,: "grnryp,
See reverse side for additional instructions and qua lifications. GIBSON COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Sheila Almon
Taxing District Key number/legal description Record number Page nu b
Gibson 26-18-24-202-000.454-026 26/60D3°6l.17
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
March 1,anent year March 1,current year date of application legal or equitable owner?
28900 22500 60714 Il 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
El 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)
501 Cross Pointe Blvd, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,sate,and ZIP code)
Does applicant own property in any If yes,what county? I What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county , property for -
in Indiana? yes 0 No current year? 0 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 line of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR _
Deduction approved in the amount cf.
20 I 20 20 20 20 I 20 20
ISignature of County Auditor I County I 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
ner I contract buyer of the aforementioned property on date application is filed.
nature(owner's full name) Data(monlLiiday,.yyar)
Full resident address of applicant(number and street,city,state,and ZIP code) o` �,(/ l/(J�
305 South Main Street, Ft:'Branch, IN 47648
Person authorized by duly executed Power of Attomey or by IC 6-1.1-12-01 Date(month,day,year)
Address of authorized person (number and street.city,state.end ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed 510,000.