HomeMy WebLinkAboutMortgage_Shelby , ,.. , . , , . . • . . : . . ,• ,
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS county Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
,,,v4:.;,/,,,,, Jc)i) 223 Prescribed by Department of Local Government Finance 0 .710ec)
tI"' r .A.,l. ,".„1}dtt• File Mark
INSTRUCTIONS: j" -- 144 Ikile 1 klie'S 1
To be filed in person or by mail. V JAN' g 4 212 F e with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
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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. ounty Recorder
2) Mobile/Manufactured Homes not assessed as Real Properly:Must file with the County Auditor of the county
where the property is located during the twelve(12)months before March 3/of each year the deduction is sought. '
See reverse side for additional instructions and qualifications.
rApplicant(owner or contract buyer-See restrictions on reverse Side) -' '' -
James Shelby and Jennifer Shelby . ,, 10/ 36/2 ()
Taxing District Key number)legal description 1 Record nmber Page number
f,),atekg: 0 aS : 26-12-08-204-001.479.-028 2,072-0 oc)03.4-R
g,...: ioda',value;0.01:iii§0Was of Mortgage/Contract indebtedness unpaid as of .. montpoloiihteget•fritebtediiiss unpaid as of ,Is the appllcap11sole
assessment ClaW0.4413WIti/ a_r : assessment date,current year dat#:floiOlion. , , 'legatOr , b16-,(4.onerti
56-ta : , ' .
,Yes 0 No
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If no,what is his I her exact share of interest? ' If owned with someone other than spouse,indicate with whom
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.11 name on record is different than that of ajoblicaht,indicate below: -' " -". ' '" - -— Islhe property in question:Annually Assessed
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• ,E Real Property El Annually Assessed
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Mo Ile Home(IC 6-1.1-7).,., _ _, . , _ ...
Name of mortgagee or contract seller .1.--1.1 -
Mortqage,Masters of Indiana, Inc. ISAOA :
71;ddieiiiif mortgagee or contract seller(iiiirnberand street,city State and 20 odde)- JAN 0-5.102i """
501 N Crass Pointe Blvd Evansville,IN 47715
Aciazti , ,
gINTYAl t?'2.1.1-0 - ' '. - -
Name'df assignee or other,oWner or Kolder of mortgage .
. GIBSON CO _ -
Address of assignee(number and street;city,state,and ZIP code) R
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Does ownmperty in any ' If yes,what county? • What Taxing District' ` Has this deducti een requested ;! If yes,State amount of deduction
: :Other,C91.1(4 •,,... .,. on property for
I, frftikilinef Illie.t', 0 No !, . current year? Yes Iii No
A person is not entitled to this deduction unless the person has a balance on the persO n's mortgage o co ract 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 offs )th is the basis for the deduction.
COUNTY AUDITOR
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.1 Deduction approved in the amount of:
! I- - • , _ , ., . ,
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'; 20, •,; 20. ,
2
Signature of County Auditor d k) County • Date(mo h,
: I We certify under the penalty of perjury that the above egoing information is ta
e nd correct and that the applicant i a resi ent of Indiana and
tier/contract buyer of the aforementioned property on date application is filed:,Si 42re,:(owner's full name) ..,..---..,..:,- 1 Dale(month day,year)
''.:' ''{ --: ;'-; '•-•. .:-....:--:,,.! ‘..,,,, „. --6A' -2e2Z
,._ _ . ....
I resident ad •ss of- .icent(number and street,city state,and ZIP code)
304 E y or Ave, Princeton, IN 47670
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. •&soli 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)
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The penalties for perjury can include imprisonment up to two and a .1 1:ft.L.nd a fine not to exceed$10,000.