HomeMy WebLinkAboutMortgage_Ford (3) c,i.y,.• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
�;1 FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R14/1-20) Gibson 0 Z 2022
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail. Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. 0 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)
Chelsee J. Ford
Taxing District Key number/legal description Record number Page number
Princeton 26-12-07-303-001.582-028/HALLS 2ND 44 PT r- 22 s—S
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the appl t the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$0.00 $97,500.00 0 Yes 0 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: the property in question:Annually Assessed
Real Property ❑ Annually Assessed
r Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller FILED
Mortgage Masters of Indiana, Inc., ISAOA
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
501 N. Cross Pointe Blvd., Evansville, IN 47715 JUN 2 9 ZOZZ
Name of assignee or other owner or holder of mortgage
Address of assignee(n •- . heet,city,state,and ZIP code) y 44xZLL �- AUDITOR
G►BSON COUNTY
Does applican in .rope • If yes,what county? What Taxing District? Has this deducti en requested If yes,state amount of deduction
other county • es � NO on property for, Yes ❑ NO
in Indiana? current year?
A person is • e title• to is deduction unless the person has a balance on the person's mortgage or o ract indebtedness that is recorded in the county
recorder's office( • luding any home equity line of credit that is recorded in the county recorder's office)th is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County AuditorCYIP County
Gibson DaJga e rr�nth, aze.,L
�lJ'-"- �� (terf 'C � C/r
I/We certify under penalty of perjury that the abov nd going information is true and correct and that the applicant is ident o Indiana and
owner/contract buyer of the aforementioned property on-date application is filed.
F2{own7Iname)
Donayyearr aC� e�l resident address of applica (number and street,city,state,and ZIP code)
603 S. Hall St., 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)
n.a,.e.,aere.Ans..,e.:,It,...a..r...-t,,..a i... ' ..,er......M h.,i,a...r a haK,ioa.c and a fine not to exceed$10,000.