HomeMy WebLinkAboutMortgage_Krieg (8) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
st'%Y a FOR DEDUCTION FROM ASSESSED VALUATION County Township Year
j •`t t� State Form 43709(R13/10-15) D t OA 6 �6-�
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`a Prescribed b De artment of Local Government Financ RECEIVED S `1
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INSTRUCTIONS: uiS. (So 1 . .r71
To be filed in person or by mail. I, \rf AUG 2 7 2019 Fo filed with:
Filing Dates: 1) Real Property:Must be completed anti dated t Ore ca ear 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)
Krieg , ft'1 t ' g1_sl aa-o
Taxing District Key number/legal description Record number Page number
Ft. Branch 26-19-19-103-000.096-026 c .) tO ( X3'7 3
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� c� o O Lylegal oreequijteble owner?
1 vt —1 0 J• 'Yes ❑ No
If no,what is his/her exact share of interest? If owned with someonelo4 ther than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
Aka]Property ID Annually Assessed
t Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller IV
Mortgage Masters of Indiana, Inc. ISAOA
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) AUG 2 • 2020
501 N C,ass Pointe Blvd Evansvife,IN 47715
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? ❑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 20 20 20 20 20 20
Signature of County Auditorill\ /�� County ` Date(mor}tbJ d y arjI/We cert•► under the penalty of perjury a1 to above and foregoing information is trt a nd correct and that the applicant is a re ident of Iiana and
owner/ o,tract buyer of the afore r-. tione property on date application is filed.
ign tur-(o,y' er's NI 'ame) " D to(mptgth,day,year)
ull resident address of applicant(number and street,city,s ZIP code)
1004 S Center St, Fort Branch, IN 4764;
Person authorized by duly executed Power'of Attorney or b'IC 6-1,1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,city,state,and ZIP code)
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