HomeMy WebLinkAboutMortgage_Kasper 4Pf s STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
,r.,, �; County Township Year
�o�/$ 'r o FOR DEDUCTION FROM ASSESSED VALUATION
"I, 'F: ..� -�}:I State Form 43709 R14/( 1-20)
r Gibson 2021
; � C/�
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Prescribed by Department of Local Government Finance
RECE E
INSTRUCTIONS:To be filed in person or by mail.� itic /(L JAW 2 7 2021 File Mark
��-l• 'Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property County Auditor
is located on or before January 5 of the calendar year in which the property taxes are first due and payable. County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
KAYLA D.KASPER
Taxing District Key number/legal description Record number Page number
26-12-18-201-001.496-028 202- 3 1
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,eequitja le owner?
117,171.00 L�'Yes ❑ No
If no,what is his I 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: pii- -'Is
property in question:Annually Assessed
Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Acceptance Home Mortgage,LLCM
r
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) � '�1' n
101 Plaza East Boulevard,Suite 232,Evansville,IN 47715 . i,' j
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) o9uAir
quoiron
Does applicant own property in y If yes,what county? What Taxing District? Has this deduction been quested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes No current year? es ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage o ontract 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 Au / c idck� County CC q3Q� Dat i(mo2, dy year)S C-172A
•
I I We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
Sin tur (own is II'ame) Date(month,day,year)
January 20,2021
Full resident ddress of applica)t(number and street,city,state,and ZIP code)
1104 South Race Street,Princeton, IN 47670-3032
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
January 20,2021
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 CON RC I EB D
Name of applicant Name of mo agee or c ift
e
KAYLA D.KASPER (lei hi 11 6 "IP/C C)
Date filed(month,day,year) Amount of indebtedness J,; iIT� i t t.-- oCa
Key number/legal description '" N 1 l
pip, %40' '
26-12-18-201-001.496-028 C N I AU 2 F 1
Signature of ounty gs itor/ ounty Recor County \ OUY B oonth,day,year) N :_j