HomeMy WebLinkAboutMortgage_Auxier (2) 4,E.-k, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear
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_-._ - ,,•li; FOR DEDUCTION FROM ASSESSED VALUATION
4. State Form 43709(R12/6-14) Gibson -UUi nui i - 2021
`'�`a''-=t'' Prescribed by Department of Local Government Finance - -- -
INSTRUCTIONS: QuivIWA T K�i\� , I• b. 20 '� File Mark
To be filed in person or by mail. 1 • 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 ❑✓ 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)
Joshua Auxier and Laura M. Auxier
Taxing Dist Key number/legal description Record number Page number
,026 -1- 26-18-13-404-000.152-026/OLD PLAN 24/25/23PT, Gibson County ae 0 0 g_c� q
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of application legal or equitable owner?
$282000.00 VI 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: perty,-ju-gpeio ,nnually Assessed
tI I Prolierty II Ap ually Assessed
i " L-obile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Mortgage Masters of Indiana, Inc. JUL 1.6 1020
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
501 N. Cross Pointe Boulevard, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage
GIBSON COUNTY AUDITOR
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property i 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 t 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 20 20 20 20 20 20
Signature of County Audito County '\ Date(month,day,year)
QNnrn Cc_r___S\33 JY'11 , • \10- Do 20 .
I/We certify under the penalty of perjury that the above and foregoing information is true nd correct and that the applicant is a resident of Indiana and
ow /contract buyer of the aforementioned property on date application is filed.
(owners full n�r�e) ,` Date(month,day,year)
/J'vl(I 7/7/2020
Full resident address of applicant(number and street,city,state,and ZIP code)
101 South Main Street, 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)
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 MORTG .R i ONT�A T N IIBTEDNESS
Name orflap�lliiccant /n - Nam o m g.t.ee,r ondjad e.JU�Y Lla ,1" Lail IA �( AA(,f f r ., S tLr1
Date filed(month,day,year) Amount of indebtedness JU ,202,Taxing District
Key number/legal descri on _ n L Ck('�()
/ (.�-- .l� Li ng- 152- b 2020 v_I
Signature ofMy tiglitor/County COffib(1I TY AUDITOR Date(month,da,year)
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