HomeMy WebLinkAboutMortgage_Harvey (10) l o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County hip
TcvnS,,,N Year
•
ra `e FOR DEDUCTION FROM ASSESSED VALUATION g
• State Form 43709(R72/6-74) 2J �, 2018
•. jl Prescribed by Department of Local Government Finance ,,
INSTRUCTIONS: File Mark
To be filed in person or by mail. NOV 2 , 4,0l6d with:
Filing Dates: 7) 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's ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. • it !q) aunty Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the c. • ifi n tyPt
where the property is located during the twelve(12)months before March 31 of each year the de TIO0 N Y AUDITOR
See reverse side for additional instructions and qualifications.
Approant(owner or contract buyer-see restrictions on reverse side)
David G. & Shannon R. Harvey
Taxing District Key number/legal description Re9onl o\b page
26-12-07-303-002.810-026/Pt.SW 7-2-10 .019 Ac.Halls 2nd Pt.Lot 23-Gibson County 11/ ���((( CC.JJJ
L
Assessed value of real property as of March 1, /rent Contract indebtedness unpaid as of Mortgage/Contact indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of application legal or equitable owner?
Ij 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 .
NI 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 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? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes S NO current year? ❑Yes is 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 I
Deduction approved in the amount of:
20 1 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,yea-)
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
o er/contract buyer of the aforementioned property on date application is filed.
Si '✓u (owner's hc0-gam�)1 1 , Date(month.day,year)
L)y \JY )YjJ / I — ZD - ) 7
Full resident address of applicant(num street,city,state,and ZIP code) .
303 West Pinkney feet, Princeton, IN 47670
Person authonzed by duty executed Power of Abomey or by IC 6-1.1-12-0.7 Date(month,day,yea)
Address of authorized person (number and street.city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S 70,000.