HomeMy WebLinkAboutMortgage_Durbin (2) t�_1 7.. STATEMENT OF,MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear
:-`=a-.t.,; FOR DEDUCTION FROM ASSESSED VALUATION
.si!`. 4 �� State Form 43709(R14/1-20)
� RECEIVED Gibson Union 2020
Prescribed by Department of Local Government Finance
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INSTRUCTIONS: To be filed in person or by mail. 11 NOV 2 LOLQ File Mark
�`�M� . F rm filed with:
Filing Date: Form must be completed 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 property is
located on or before January 5 of the calendar year in which the property taxes are first due and payable. ❑ ounty Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jarrod Michael Durbin and Katelyn Elizabeth Ann Durbin
Taxing District Key number/legal description Record number Page number
025 26-19-15-300-000.567-025/PT E SW 15-3-10 1.388 AC D-10,Gibson County 0 a� 0 00 S i
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 or equitable owner?
$189905.00 i I 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 -- --- -
seal Property ❑AnnuallyAssessed
{, Mobile Home(IC 6-1.1-7)IL 4..
Name of mortgagee or contract seller ^f"
Mortgage a e Masters of Indiana, Inc.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) NOV 2020
501 N. Cross Pointe Boulevard, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) GIgSON COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deducti n b n requested If yes,state amount of deduction
other county on property for
in Indiana? III Yes Ii. current year? Yes ❑No
A person is not entitled It this deduction unless the person has a balance on the person's mortgage or n ct 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)tha 's the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 0 20 20 20 20 20/
Signature of County Auditor < County , Date(mo th,day,yea
gab ini _____D 3o4 , It .
I/We certify under the penalty of perjury that the above and foregoing information is ru and correct and that the applicant i a resident f Indiana and
owner/contract buyer of the afore ntioned property on date application is filed. _
ign re owners full name) Date(month,day,year)
(//']/JU , 11/13/2020
r ident address" of applicant( and street,city,state,and ZIP code)
7 19 South 300 East, 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 MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant - Name of mortgagee or ,• : elle
Jarrod Michael Durbin and Katelyn Elizabeth Ann Durbin Mortgage Mas - s t '
Date filed(month,day,year) Amount of indebtedness iflgr ' D
11- 2_,V1/4•`2r02 $189,905.00 025 0 `tri
Key number/legal description (�,,, ��
26-19-15-300-000.567-025 ®v 202"!�IQ_-) Sy,r�
Signature of C.+ A or/County Recor er (�-30 County `-� Dat (month day,year) ,�'1 Np �j
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