HomeMy WebLinkAboutMortgage_Seltz k STATEMENT OF MORTGAGE OR CONTRACT INDEBTE S County Township Year
.-- rr. FOR DEDUCTION FROM ASSESSED VALUATION
N ' State Form 43709(R13/10-15) Gibson Owensville 2020
°ai8-r Prescribed by Department of Local Government Finance RECE; ,,..1
INSTRUCTIONS: ?Coi\orl-
AUG 1 71019 File Mark
Form filed with:
To be filed in person or by mail. Al
Filing Dates:1)Real Property:Must be com eted and dated in the calendar year for which the deduction is sought. County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the ❑ . County Recorder
property is located on or before January 5 of the immediately succeeding calendar year.
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)
Andrew M.Seitz , Sarah M. Seitz
Taxing District Key number/legal description Record number PagQ nuyr4bb
Owensville 26-17-01-404-000.373-022 �� �Ul(�
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 le I or equitable owner?
150,600.00 149,600.00 Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with om
If name on record is different than that of applicant,indicate below: Is a property in question:Annually Assessed
Real Property 0 AnnuallyAssessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller la
Mortgage Masters of Indiana,
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
501 N. Cross Pointe Blvd, Evansville, IN 477154S, ,, 11
Name of assignee or other owner or holder of mortgage �A
�. .�
Address of assignee(number and street,city,state,and ZIP code) •
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ls
Does applicant own property in ny If yes,what county? What Taxing District? Has t .1:', l j t q ted If yes,state amount of deduction
other•county- on propertef$c ' .s
in Indiana? 0 Yes No curren,a: ,i�� °. ❑No
A person is not entitled t this deduction unless the person has a balance on the person's mcugag- ?- JPiiact 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 offrcOthat is the basis for the deduction.
COUNTY AUDITOR �0��
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Audi At 1 _^ County Date(month, a ,Tar)
♦ . '�7L ��01 g rL02�0
I/We certify under the penalty of pert 4i e above and foregoing information is tru d correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signatiii: rlers fell "ame) Aia- - / Date(month,day,year)
j
°
F I r sid hw.tzdre f applicant(number and street,city,state,an. 'code)
302 N First St, bwensville, 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. 45683