HomeMy WebLinkAboutMortgage_Georges (5) trni), STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
°a_ _ ° FOR DEDUCTION FROM ASSESSED VALUATION
Itai State Form 43709(R12/6-14) Gibson Barton 2020
Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
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 sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is I] 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 file with the CountyAuditor of the county
where the property is located during the hveNe(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)
Thekla Georges and Alex Manion
Taxing District Key number/legal description Recq� Page number
001 26-20-22-400-001.903-001/Pt NE SE 22-3-9 1.001 AC, Gibson County 2 3nu Alj (1
A vssed value o/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 application legal or equitable owner?
in 1'-1 , 3R ' El Yes ❑ No
If no,what is his/her exact share of interest? If arced 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
..lkohle Home(IC 6-1.1-7)
Name of mortgagee or contact seller VIL 11�p./q➢
Mortgage Master 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 pGG 8 2419
Address of assignee(number and street,city:state.and ZIP code)
artVV:ectigbi.r;OR
Does applicant own propqrty in any If yes,what county? What Taxing District? Has this deduction been rgq 15QYstate amount of deduction
other county on property for UI (c)N
in Indiana? ❑Yes No current year? ❑Yes DI No
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
Signs' of County Audit ( t4.42 Count' Date(month.day,year) 9
II We certify under the penalty of perjury that the a o e and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned prope on date application is filed.
Si t (owne t name)/' /�f li� r7 „ 1 Date( onpr��y9a��
F resident address of applicantIc (numbern /ndl sstreet,city,state,and ZIP code) �!]f/I ill
8011 South 950 East, Elberfeld, IN 47613
Person authorized by duly executed Power of Attorney 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 half years and a fine not to exceed$10,000.