HomeMy WebLinkAboutMortgage_Maikranz STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
z FOR DEDUCTION FROM ASSESSED VALUATION
y State Form 63709 Department 16) � , •_ d City
.„ Prescribed by Department of Local Government Finance ��
INSTRUCTIONS: g b'1 'fll gif!4
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 soue 2 n I
Must be filed or postmarked with the County Auditor or County Recorder of the county where this prbpedy ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property Must Me with the County Auditor of the county ,A�
where the property is boated during the twelve(12)months before March 31 of each year the 4jp
derfp' 1eM1(.1T�
See reverse side for additional instructions and qualifications. (W
Applicant(owner a contract buyer-see restrictions on reverse side) r "'r�rT�
G',a3�;< Cam:;;;T'. . R
Samantha J. Maikranz and Mark A. Weightman (F-p ,,21i 1
Taxing District City Key number/legal description I Rey nyln Page number; t
Oakland Ci 26-14-18-201-000.825-007 111"`=///VVV__y)t /l/lUtpd)
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
March 1,anent year March 1.current year date of ap lication ry��y� legal or equitable owner?
1'O OR .w 0 Yes a No
If no,what is his I her exact share of interest? If owned with someone other than spouse,indicate with whom
50 7'b Mix„ii A. 1,0enq k-t wen.
If name on record is different than that of applicants indicate below Is the broperty in question:Annually Assessed
I7J 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,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 i 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 0 N
A person is not entitled t 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 of:
20_ 20 20_ 20 20 20 20
Signature of Canty 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 t aforementioned property on date application is filed.
Signature(owner's roll name l /�/, // n 4 % Date(month,day,year)
U ( rU�/�� �� IIYdee) 2 -C�_ /8
Full resident address of applicant(number end street,city sj,�te`�.�rd ZIP code)
914 N Polk Dr., Oakland City, IN 660
Person authorized by duly executed Power of Attorney or by IC 61.1.12-0.7 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 half years and a fine not to exceed 510,000.