HomeMy WebLinkAboutMortgage_Kroledge e sr�TP� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear
"�f ==t\I FOR DEDUCTION FROM ASSESSED VALUATION;et
t<':,:�ti%a State Form 43709(R12/6-14) Gibson f1 2021
' `=•�`' Prescribed by Department of Local Government Finance
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INSTRUCTIONS: �1(�,�,
File Mark
To be filed in person or by mail. ?c;s, \TXCL W1 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. ❑ 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) •
Michael C. Kroledge
Taxing District Key number/legal description Record number Page number
001 26-20-02-201-000.078-001/Pt NE 2-3-9 .96 A, Gibson Countyp 501
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as bf��rr Is the applicant the solb
March 1,current year March 1,current year date of application legal or equitable owner?
$75656.00 yi Yes El No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
-- If-name.on record is different than that-of applicant,-indicate below: - -Isthe-property-in-question-AnnuallyAssessed
❑✓ Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller r�C
Mortgage Masters of Indiana, Inc. So L=� h /V sel0
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
501 N. Cross Pointe Blvd., Evansville, IN 47715
Name of assignee or other owner or holder of mortgage OZOZ 9 0 83J
Address of assignee(number and street,city,state,and ZIP code)
s1 1 15—
Does applicant own property in a y If yes,what county? What Taxing District? Has this dedu n ee� - este.$ a amount of deduction
other county on property for
in Indiana? Yes o current year? ❑El Yes ❑No
A person is not entitled to is 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 Cou y ditor . 1' \ 'n County Date(,on'hid ,year)
,,� I /W�`l s 202
/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a re ident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
- -- Signature(owner's full name) — - - -- - Date(month,day,year)
/-1-. G � �� / 1/29/2020
Full resident address of applicant(num er and street,ci state,and ZIP code)
4817 South 1025 East, 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$10,000.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name f mortgagee or contract seller Y
-
OA ci..c��l C 1(-- co 1 e_ck -Q �-k— -� a —=}� ,
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Date filed(month, ay ar) Amourtt-bf indebtedness vTaxing District
'2-
1 S ie S (0. a d °a }FEB 0 6- 2020
Key number/legal escription
'DSO ^' ) -0-a • a® .0 co. C)i5c --n0 1
Signature of Co(wayAuditor/County R rder County Oe.1 Date .:, ��,� t,
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