HomeMy WebLinkAboutMortgage_Rea r, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
i - FOR DEDUCTION FROM ASSESSED VALUATION. ///^^^t 20`�2
IY' `F+ State Form 43709(R13/10-15) sor) d 2._.. -
.. ;-„-:P Prescribed by Department of Local Governmente Finance� (nce heal,
INSTRUCTIONS: IC e�u�:f`,-T-4y N I,2 R- 2Z - File Mark
To be filed in person or by mail. t\ Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calen ar year for which a deduction is sought. Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property istY
located on or before January 5 of the immediately succeeding calendar year ACoun
County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the 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)
Rea, Lucas Evan
Taxing District Key number/legal description Recold number Page nu 7r
Union 26-18-25-200-001.092-025 OC) ?1` INCH
0
Assessed value of real propertyas 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 equitable owner?
$227,272.00 El 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
RI Real Property ❑ Annualy Assessed
Mobile lHome(IC 6-1.1-7)
Name of mortgagee or contract seller
Mortgage Master of Indiana, Inc.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) FILED
501 N. Cross Pointe Blvd., Evansville, IN 47715
Name of assignee or other owner or holder of mortgage Address of assignee(number and street,city,state,and ZIP code) FEB 9
2022
Does applicant own property in a If yes,what county? What Taxing District? Has this deductio que ted 5.-ves,pije armount tof deduction
other county on property for Glr ,j/(r O�
in Indiana? ❑Yes No current year? S CIUNTY At Mt-T-0R
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 that's the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 (---
20 20 20 20 20
Signatu fCgErnty uditor County Date( t ,) , Oin 2- 4y. e •
I/We certify under the penalty of-perjury that the above and foregoing information is and correct and that the applicant i�a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature owner's full name) Date(month,day,year)
/ �_..-:., .�---- 02/02/2022
Full resident address of applicant(number and street,city,state,and ZIP code)
8848 South 100 West Road Fort Branch, IN 47648
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)
— ... __._:__,.. :_. • .,,....•,....,....,.,-.,.+-....if,.Pars and a fine not to exceed R10.000.