HomeMy WebLinkAboutMortgage_Shepherd q STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ;� � Year
e FOR DEDUCTION FROM ASSESSED VALUATION
i State Form 43709(R12/6-14) 26 2018 •
Prescribed by Department of Local Government Finance A1o`I i rk
,�A�
INSTRUCTIONS:
NOV
To be tiled in person or by mail. F filed - :
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 pro p-t1 County Auditor
located on or before January 5 of the immediately succeeding calendar year. OI6SON COUNTY ttgr xt 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.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jennifer L. Shepherd
Twang District Key number/legal description Record number Pa umteir ,
26-20-14-301-000.021-002/Pt. NW SW 14-3-9 .31 Ac. -Gibson County 2 Q �- �oj -J„J���-'
Assessed current year real poperty as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March
year March 1,current year date of application legal or equitable owner?
D yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate wah whom
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
GI 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,stare,and ZIP code)
501 N Cross Pointe BLVD 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? Wnat Taxing District? Has this deduction been requested If yes,state amount of deduction
other county ,property for
in Indiana? ❑Yes No current year? Yes GI 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 fine 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 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.
(owner's AS name) Date(month,day,year)
t/l y • 11/10/2017
Full r en Qdre�o(aSplicant(n mber and street,city.state,and ZIP code)
9 591East Main Street, Mackey, IN 47654
Person authorized by duly executed Power of Aftomey 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)
The penalties for perjury can include imprisonment up to two and a hal or -•N °n- -- - -- - •