HomeMy WebLinkAboutMortgage_Cox (18) w ;z STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4, 4> i FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(RI1 6-09) Gibson Owensville 2020
'►��_ ,r+ Prescribed by Department of Local Government Finance
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INSTRUCTIONS: File Mark
To be filed in person or by mail.
Filing Dates: 1.) Real Property: Must be completed and dated in the calendar year for which the deduction is sought. For filed with:
Must be filed with the County Auditor or County Recorder of the county where the property is located
on or before January 5 of the immediately succeeding calendar year. County Auditor
2.) Mobile/Manufactured Home not assessed as real Property: Must file with the County Auditor of the ❑ County Recorder
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)
* Bo E.Cox and Alexis M.Farr
Taxing District Key number/legal description Da( Record number Page umbe
* * Lot 18,TIMBERLAKE,-• tp- (�] -O� -y 00 o oq 7>�3* o * ` T
Assessed value of real property as of Mortgage/Contract indebtedness unpaid Mortgage/Contract indebtedness Is the applicant the sole
March 1,current year as of March 1,current year. unpaid as f date of ap lic ti n legal or equitable owner?
* $0.00 * $0.00 * I GI 154 11 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
El Real Property 0 Annually Assessed
J Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller FILE
* Acceptance Home Mortgage,LLC
Address of mortgagee or contract seller(number and street, city,state,and ZIP code)
* 101 Plaza East Blvd.Suite 232,Evansville, IN 47715 OCT 2 9 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street, city,state,and ZIP code) � n . �1r
GIBSON Lr�G.l1}4 YIi(f.�... ,;: JI
Does applicant own property in any other In yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
0 Yes 0. No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signatu o County County Date(month, day,year)
I/We certify under the penalty of perjury that the a ve and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned pro erty on date date application is filed.
Signature(owner's full name) �I�� . �/� Date 7,th -y,o2 )� /l� ivv �uFull resident address of applicant(number and street,city,state,and ZIP code)
* 7981 West 500 South,Owensville,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)