HomeMy WebLinkAboutMortgage_Schurman easiZA STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
;;TA>;,'< FOR DEDUCTION FROM ASSESSED VALUATION
.a Gibson 0 2021
e State Form 43709(R14/1-20)
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by maiL Form�fi d 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. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jordan C.Schurman and Chelsey E C Schurman
Taxing District Key number/legal description Record number Page number
Owensville 26-11-31-300-004.320-021 /PT SW 31 2 11 4 AC O�Q I eod'•
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,�o..r,//equitable owner?
$0.00 $277,628.00 4es ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name an record is different than that of applicant,indicate below: Is th roperty in question:Annually Assessed
eal Property ❑Annually Assessed
Mobile Home(IC 6-1-1-7)
Name of mortgagee or contract seller
Mortgage Masters of Indiana, Inc_ 4,67404
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) F`B cc
501 N. Cross Pointe Blvd., Evansville, IN 47715 1'
Name of assignee or other owner or holder of mortgage
14‘9
Address of assignee(number and street,city,state,and ZIP code) V/�/COOF`
Does applicant own roe in anyIf es,what county? What TaxingDistrict? Has this ded ch' B d If yes,state amount of deduction
PP property rtY/ Y tY• L �
other county Yes L►1 No on property for �77��,,,
in Indiana? current year? �Y6S Ly'iQ10
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract 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 Audi r (� , 1 p `, County Date(month,day,year)
L.C1� Vim_ W�� `1 � hC Gibson c — t i—c c (
I/Vtte certify under penalty of perjury that the above and f egoi formation is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signatu�wner' fullt %' r Date(month,day,year)
K. l ,r, ,_,/,„ ;,,,1;",f /�L!ir LC,(Al�t_i(f J her.,(:l:,) ?._i,�,/) • `l - 1
tull resid�r--address of applicant(number and street,city,state,and ZIP code) /
6468 W Stalheim Ave, Owensville, IN 47665
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 mortga.-- •=•..ntractseller
Jordan C.Schurman and Chelsey E C Schurman Mortgage ‘'a; rf Indiana, Inc.
Date filed(month,day,year) ^ Amount of indebtedness Taxing District
01`1 -"papa,( $277,628.00 Y Owensville
Key number/legal description e�
26-11-31-300-004.320-021 /PT SW 31 2 11 4 AC s �, rI
Sign ture of CountyyAuditor/C unty `o co my A 1. ,,p� Date(month,day,year)
Sign
c 0 CU . �J 0 I , ''Gibs rry"�' `�ibiftv0ck —(�---- 00e
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