HomeMy WebLinkAboutMortgage_Himmelhaver STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
-,A.„ FOR DEDUCTION FROM ASSESSED VALUATION
5 17 „d`�, State Form 43709(R11 6-09) RECENEDGibson Haubstadt 2021
fe4—. , Prescribed by Department of Local Government Finance
INSTRUCTIONS: f , f(U�.J'V' ` FEB 0.12021 File Mark
To be filed in person or by mail.
Filing Dates: 1.) Real Property: Must be completed and dated the calendar year for which the deduction is sought. Form 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)
* Matthew V.Himmelhaver and Ashley K.Himmelhaver _d 2,4
Taxing District Key number/legal description �6�23 11I 3�- Re ord number Pa mber
* O29 . * COUNTRY AYRE EST 22 D-9 0" 001 _410 21
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 of date of application legal or equitable owner?
* $0.00 *•$ ! /J 1 W * $0.00 El Yes ❑No
If no,what is his/her exact share of interest? / f with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: • t.{ ' f Is the property in question: Annually Assessed
❑x Real Property ❑ Annually Assessed
Fr 0 1 20?1 Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
* Mortgage Masters of Indiana,Inc. akilli)
Address of mortgagee or contract seller(number and street, city,st n/ q ) AUD
* 501 N Cross Pointe Blvd,Evansville, IN 47715 GpUNTY
rrun
Name of assignee or other owner or holder of mortgage Gt13.+014
Address of assignee(number and street, city,state, and ZIP code)
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 0 Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor 1M ;. County \ Da a(month day, ear)
,1 3�Orl I. `.�jiL1
II We certify under the penalty of perjury that the above and foregoing information is tr and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Si reixers full a e) r Date month,day,year)
Full resident address of applicant(number and street, city, te, and ZIP code)
* 12280 S 200 E,Haubstadt,IN 47639
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)