HomeMy WebLinkAboutMortgage_Sievers STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
gprt• State Form 43709(R14/1-20) Gibson 0 '- 2021
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Prescribed by Department of Local Government Finance , RECEIVED
` _(, I�1 File Mark
INSTRUCTIONS: To be filed in person or by mail. Is� I `l�l�/ 1 r FEB 12 2021 Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. Q 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. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Brock M. Sievers and Emily L.Sievers
Taxing District Key number/legal description Record number Page
Princeton 26-12-05-300-004.135-027/PT S 5 2 10 4.79 AC 3
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the
e applicant the sole
assessment date,current year assessment date,current year date of application legal r uitable owner?
$0.00 $440,000.00 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 h property in question:Annually Assessed
eal Property ❑ Annually Assessed
IL Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Mortgage Masters of Indiana, Inc.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) FEB2021
501 N. Cross Pointe Blvd., Evansville, IN 47715 f"GD
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) GIBSON COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduct n n requested If yes,state amount of deduction
other county El Yes El No on property fo Yes El No
in Indiana? current yea .
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or con 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)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 Auditor County Date(month,day,year)
I Gibson Z' il•7i02,1
I/We certify under penalty of perjury that the -.afi• and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the forementioned property on date application is filed.
qi tur (owner's full n me) Dat�( on y ( (Full i en address of ppl ran street,city,state,and ZIP code) �1
980 E Taftown Rd, P ' n, IN 47670
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)
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