HomeMy WebLinkAboutMortgage_Morgan (11) ^na STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
°a-_ ; : FOR DEDUCTION FROM ASSESSED VALUATION
'.� '' State Form 43709(R12/6-14) Gibson Columbia 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 ❑✓ 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 twerve(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)
Joshua N. Morgan
Taxing District Key number/legal description Rerpq nun r Pre9e num r
007 26-14-18-304-000.145-007/South Enlg 11 Pt/12 Pt Blk 10, Gibson County �e.\/ ✓(
Assessed value of 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?
$55555.00 p 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 Acwssed
0 Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Mortgage Masters of Indiana, Inc.
Address of mortgagee or contact seller(number and street,city,state,and ZIP code) 7/-
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) , f�Does own grope i any If yes,what county? What Taxing District? Has this r eduction been requested yes,state amount of deduction
inI other county on rent property for
th Indiana? ❑Yes �(`'({P��No current year? ❑Yes r �No n'Q
A person is not entitled to tFk deduction unless the person has a balance on the person's mortgage or contract irtdtbfednekl tMM 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
k/.
Deduction approved in the amount of: GIBSON COUNTY AUDITOR
20 20 20 20 20
Signature of Count'Au R ; Ci County Date(no ,
1�f"1 C/t si fl
I,We certify under the penalty of perjury that th a owe and foregoing information is true and correct and that the applicant is a esid t of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
iSignature • / name) Date(month,day,year)
8/19/2019
Full sident address of applicant(number and sweet,city,state,and ZIP code)
26 West Oak Street, Oakland City, IN 47660
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 S10,000.