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HomeMy WebLinkAboutMortgage_Randolph Q�� 7, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County p Townshi Year , ' `j`� FOR DEDUCTION FROM ASSESSED VALUATION �-;a State Form 43709(R12/6-14) Gibson Patoka 2020 ( f ems 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 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) . Blake M. Randolph Taxing District Key number/legal description Re rd number P ge number 028 26-12-07-102-002.779-028/Chas Brownlee 16 PT, Gibson County �©� ON 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? $97,474.00 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 Assessed 12 .P-.I Property ❑ Annually Assessed Mobile Home(IC 6-1.1-7) ii. Name of mortgagee or contract seller ,,, Mortgage Masters of Indiana, Inc. 1 Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 501 N. Cross Pointe Blvd., Evansville, IN 47715 OCT 3 2019 Name of assignee or other owner or holder of mortgage Address of assignee(number and street,city,state,and ZIP code) GIB SON COUNTY AUDITOR Does applicant own prope 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? III Yes '1 No current year? ❑Yes ❑No A person is not entitled to hi •eduction 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 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. Si•••t J-(owner full name) Date(month,day,year) �` 9/26/2019 ull resident ddress of applicant(nu bar and street,city,state,and ZIP code) • 117 West Glendale Street, Princeton, IN 47670 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.