HomeMy WebLinkAboutMortgage_Murphy (2) 4*E� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'17''%-\1. FOR DEDUCTION FROM ASSESSED VALUATION County Township Year
t.':;,� '+ State Form 43709(R13/10-15) O lN��
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=. --� Prescribed by Department of Local Government Finance
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INSTRUCTIONS: File Mark
To be filed in person or by mail. F led 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)
Jacob K. Murphy and Taylor L. Murphy
Taxing District Key number/legal description cord nu ber o Page number
Montgomery Township 26-17-11-100-001.777-021 AD— �
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the a 'cant the sole
assessment date,current year assessment date,current year date of application ff,, legal or quitable owner?
2 O O v ' 06
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: FILED
Is the roperty in question:Annually Assessed
❑ eal Property El Annually
om e(C 6 )
Mobile Home IC 6-1.1-7
Name of mortgagee or contract seller
Mortgage Masters of Indiana, Inc. ISAOA CC
Address of mortgagee or contract seller(number and street,city,state,and ZIP cbrppe B 2 6 2020
501 N Cross Pointe Blvd Evansville, IN 47715
Name of assignee or other owner or holder of mortgage Ofteitt.c*dir---
Address of assignee(number and street,city,state,and ZIP code) GIt35ON COUNTY AUDITOR
Does applicant own property 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? Yes No current year? ❑❑ III Yes ❑No
A person is not entitled to 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 21 20 20 20 20
Signature of County Audito 1J_ _ _ ___
County 13 0 Datejion(b,.da yea41 ^ O
I/We certifyunder the penaltyof perjury tha 4 e�bovA-arfd •:'n information is u and correct and that the applicant-is a resident of Indiana and pgrY 9 �
owner/contract buyer of the aforementioned prope y on date application is filed.
Si natu e(owner fu ame Date(month,day,year)
L.
1' . ' '
ll r= ident address of applicant(num r 'W street,city,stat ,and ZIP co -) C
5760 S 850 W, Owensville, IN 47665
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.