HomeMy WebLinkAboutMortgage_LLC (11) M rt.. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
g' FOR DEDUCTION FROM ASSESSED VALUATION
•' - Gibson Patoka 2022
N.,r.,^: State Form 43709(R14/'I-20)
Prescribed by Department of Local Government Finance
�) 4 I File Mark
INSTRUCTIONS: To be filed in person or by mail. �P�\' �✓`U ' "ti?„.2Z Form filed with:
Filing Date: Form must be completed and dated in the calende)year for which the deductionsought. 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)
Morganside Investments, LLC
Taxing District yn' Key number/legal description RRe7corddnnursber Page r
Patsic� 1 '� 26-12-07-102-001.001-028/N 1/2 Lt 2 Warnock's Add li c�''GG))._
Zsessed 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 applicati legal or equitablejj"" owner?
$92,800.00 $10 , 0.00 2 (I/ �0 )4Vres 0 No
If no,what is his/her exact share of interest? I If owned with someoneTT other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: F L E L I the property in question:Annually Assessed
heal Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller MAY 1'6 2022
Field&Main Bank [�
Address of mortgagee or contract seller(number and street,city;state,a d /P code) a. f k--c
1020 N. Burkhardt Rd, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage GIBSON C Y AUDITORNA y O 2O2
Z
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property i any If yes,what county? What Taxing District? Has this deductio een requested If yes,state amount of deduction
other county ❑Yes No on property for Yes 0 No
In Indiana? current year?
A person is not entitled o this deduction unless the person has a balance on the person's mortgage or n 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 of County Audit ty\ (--- County Date(1th,d year 2
wcotI t�z Gibson .l 16
II We certify under penalty of perjury that the above and foregoing information Is true and correct and that the applicant Is a resid nt Indiana and
owner/contract buyer of the aforementioned property on date application is flied.
Signature(owner's full name)�/f I Date(mq/rth,day.year)
Full resident address of applicant(number and street,city,state,and ZIP code)
826 N Main Street, Princeton, 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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202200001951