HomeMy WebLinkAboutMortgage_Graham (4) .0^ 4, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
..'''' FOR DEDUCTION FROM ASSESSED VALUATION
"� L/► State Form 43709(R13/10-15) ECEI RECEIVED Gibson �Yom� 2020
N'6--'4' Prescribed by Department of Local Government Finance
INSTRUCTIONS: �„q � L J U L 0 9 2020 File Mark
To be filed in person or by mail. '"1 e- F rm 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 andqualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
CHARLES R.GRAHAM and TAMARA J.GRAHAM
Taxing District Key number/legal description Record number Page nutter
/r-T J6 'M 26-19-19-204-001.309-026 '2_0 2_o 23
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 oreequiittable owner?
244,200.00 t'es El No
If no,what is his 1 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
['Real Property ElAnnually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller .1y
d � PA
Acceptance Home Mortgage,LLC,ISAOA/ATIMA ti__ ,
Address of mortgagee or contract seller(number and street,city,state.and ZIP code)
101 Plaza East Boulevard,Suite 232,Evansville, IN 47715 JUL 10 2020
Name of assignee or other owner or holder of mortgage '--Address of assignee(number and street.city,state,and ZIP code) IP - 14 A,Y71
GIBSON COUNTY AUDITOR
Does applicant own property in,fly 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.
I COUNTY AUDITOR 1
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of Count t,R,itor County \ Date(month.day,year)
I m1` C Jo^ -7• \0. 2202o
I/We certify under the 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.
Xnat (owner's full na ) Date(month,day,year)
`.j� � ./ liliaC1t- June 26,2020
I resident address of applicant(number and street,city,state,and ZIP code)
329 E.790 S.,Fort Branch,IN 47648
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
June 26,2020
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 FILINr E ft ENT( ';NIC`R ,AGE OR CONTRACT INDEBTEDNESS
Name of applicant J ) Na'e of mortgagee or contract seller
CHARLES R.GRAHAM and TAMARA J.GRAHAM 1)(1. P'1GG ._`4`\)ffC- .1.J e QC.. •
Date filed(month,day,year) Amount i�kletlecjgeko2 - •Taxing District' . . -1
Key number/legal description ;;;. _ !�r1„�^ �S Q)
26-19-19-204-001.309-026 n' 1�1J C�J
Signature of'. n. �.uditor/County ecorde GIBSON COUNTY AU jiIY2 1 � Date(month,day,year)
�do vri , C. son - 10. 202.a