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HomeMy WebLinkAboutMortgage_Horn (2) ,� 'T•,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year • FOR DEDUCTION FROM ASSESSED VALUATION c•-� State Form 43709(R14/1-20) Gibson Q�� 2`2:2-, ': ,,a,. ., Prescribed by Department of Local Government Fin nce • RECEIVED File Mark INSTRUCTIONS: To be fled in person or by mail. qcAl‘ fi ' Form filed with: Filing Date: Form must be completed and dated in the calend year for hi he deduction is soElfa 0 2 2022 © County Auditor Must be Bled or postmarked with the County Auditor or Cou ecorder of the county where the property is County Recorder located on or before January 5 of the calendar year in which the property taxes are first due and payable. Ej See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Jason M. Horn and Tiffany P. Horn, husband and wife Taxing District Key number/legal description sR�oQ� SrtG/—Record number Page ym er C� Johnson 26-23-07-200-000.464-024 l Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of the applicant equitable the e sole oile assessment date,current year assessment date,current year date of applicationlegal $258,000.00 Q 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 the property in question:Annually Assessed F ILED ElReal Property ❑AnnuallyAse ssed 6-I.I-7) Name of mortgagee or contract seller Legence Bank Address of mortgagee or contract seller(number and street,city,state,and ZIP code) �oe�q`2. 7325 E Virginia St., Evansville, IN 47715 FEB 0 Name of assignee or other owner or holder of mortgage Address of assignee(number and street,city,state,and ZIP code) �r tBSO OUN1 AUO%TOR Does applicant own property in any If yes,what county? What Taxing District? Has this deductio n requested If yes,state amount of deduction other county on property for ' Yes No in Indiana? ❑Yes ©No current year? A person is not entitled to this deduction unless the person has a balance on the person's mortgage or nt 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)tha is the basis for the deduction. COUNTY AUDITOR Deduction approved in the amount of: 20 20 20 20 \20 20 20 Signature off C`o�uFnty Auc(i or t County F'�,�-� Dat�(rro thr'gtay, ear) az I/We certify underW the cpenalty vof perjury that the above and foregoing information is%<—, correctland that the applicant i a resi� ent of Indiana and owner/contract buyer of the aforementioned property on date application is filed. Si a C-r:�`ner's tut ek �)J��,� yt,,.,,� `.f Date(month,day,year) A +np t tier ��/7 l/rVIG�` 01/28/2022 ull residen addr of app nt(number and street,ciji,,,, state,and ZIP code) 389 E Hirsc Woods LN, 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,stale.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 mortgagee or contract seller Jason M. Horn and Tiffany P. Horn Legence Bank Date Tiled tt7¢n ,d � Amount err T Taxing oh District son 2 'G) ■1 5 Johnson Key num r/teal description �`Z G 26-23-07-200-000.464-024 '-�B Q Igtgig, Signature of County A dittor/Co order D ( T, a r) r., iri GIBSON COUNTY ,-"-.,:.i fOR