HomeMy WebLinkAboutMortgage_Bowens - � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
;I`s 2_'-A FOR DEDUCTION FROM ASSESSED VALUATION
"l `tj'',.0)� State Form 43709(R13/10-15)
'e-7i', Prescribed by Department of Local Government Finance
�e`is
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 0 County Auditor
located on or before January 5 of the immediately succeeding calendar year. 0 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)
Jes A. Bowens
Taxing',0 Key number/legal description_ Record number Page number
I nt 1-- 2�-12-I 202--ov 2 -0Q??0z Z02 o072- .
Assess`d value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of aP,lication legal or equitable owner?
$'.g4Jdf-„ , Q° ❑ 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 ro.•Annually Assessed
❑ Real P5,0y nually Assessed
a Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller "
Mortgage Masters of Indiana, Inc. ,� I010
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
501 N Cross Pointe Blvd, Evansville, IN 47715 \\� cz-
Name of assignee or other owner or holder of mortgage P J q�� JC'
4Address of assignee(number an /�k. GD
Does applicant own property in ai rs this deduction been requestedG��f yes,state amount of deduction
other county .�/ property for
in Indiana? ❑Yes ❑N aD- / rrent year? ❑Yes 0 No
A person is not entitled to this lortgage or contract indebtedness that is recorded in the county
recorder's office(including an) •der's office)that is the basis for the deduction.
- Deduction approved in the amount of:
20 20 20 20 20 20 20
Signatu of ounty Auditor County / Date(month,day,year)
51,f-.1-1- . “Z)_f1T4 - /- 7- 207n
I/We certify under the of perjury that the ab and foregoing information is true and correct and that the applicant is a resident of Indiana and
ow er/contract buyer of the aforementioned pro on date application is filed.
Signal a(owner's full e) Date(month,day,year)
---z 01/06/2020
Fu esident address of applicant(number and street,city,state,and ZIP code)
820 S. Stormont St., 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)
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