HomeMy WebLinkAboutMortgage_Sherman (3) ��
t, ,- STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS — CountyTownshipYear
'" ,,% FOR DEDUCTION FROM ASSESSED VALUATION
t '••.l'- ttj''• State Form 43709(R13/10-15) (- p 1�_�, zozo
.,.izai-/" Prescribed byDepartment of Local Government Finance RECEIVED J
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INSTRUCTIONS: 7
,�` ., File Mark
To be filed in person or by mail. YQOttV�' I JUL 0 12020 Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated Ixd 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 X 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)
Scott M Sherman and Jennifer L. Sherman, husband and wife
Taxing District Key number/legal description Record number Page number
Patoka lw,S 26-11-13-300-001.426-027 23320 2, 00
Assessed 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 application legal or equitable owner?
$124,000.00 EI 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
❑✓ P-r e-ty ❑ Mobile HomeAnnuallyAssessed
j_ . ` I`� I Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller f� .
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iii
Old National Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) JUL 01 2020
One Main Street, Evansville, IN 47708
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) GIBSON 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? ❑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 0 20 20 20 20 20
Signature of County Aud County ` Date(mont ,day year)
CC-DaSan 70112020.
1/We certify under t e penalty of perjury that the above and foregoing information is tr and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sign re(o n r amp nn ii i` �VI►p Date(month,day,year)
(�,`-►��� 06/23/2020
Full resident address of applicant(number and street,city,slat 1P cl de)
1343 S 100 W, 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.
•
RECEIPT FOR FILING ST • MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant • • r.f 'rtgagee or contract seller
Scott M. Sherman and Jennifer L. Sherma A-- -:,..2 L_ :tional Bank
Date filed(month,day,year) Amount of indebtedness Taxing District •
—7• 1• 1020 . JUP104,M30 Patoka 1 v.)--3
Key number/legal description
26-11-13-300-001.426-027 � 20 2,0•Z-�OO
Signature of Counp dud' r/CountyRecord Zt4 pty Date(month,day,year)
�%�/� GIBBON COUNTY AUDIT 04.) - 1 .'Z<l L