HomeMy WebLinkAboutMortgage_McKannan (7) �.._R�iE Q.'�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4--, '' ; FOR DEDUCTION FROM ASSESSED VALUATION
N3' Hit State Form 43709(R14/1-20)
Gibson 2022
`` Prescribed by Department of Local Government Finance
�_ File Mark
INSTRUCTIONS:To be filed in person or by mail. I G 1 , ,�tI2 LIC- 1 , _,J22 Form filed 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. County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
DAKOTA L.MCKANNAN
Keynumber/legal description Record number Page number
Taxing District �Q 2�- 5C)2-MS -
26-04-24-302-000.162-020
Assess value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of �egas lorpegl u�ntle the
owner?
assessment date,current year date of application assessment date,current year Yes ❑ No
� 125,340.00
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
F I E�TJ Is the perty in question:Annually Assessed
If name on record is different than that of applicant,indicate below: eat Property ❑ Annually Assessed
DECMobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller DC 0 9 2022
ACCEPTANCE HOME MORTGAGE,LLC
Address of mortgagee or contract seller(number and street.city,state,and Z ode) / `
1221 N Royal Avenue,Evansville, IN 47715 GIBSON COUNTY AUDITO,
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city.state,and ZIP code)
Ci
Does applicant own property i any If yes,what county? What Taxing District? Has this deducti n b n re ues If yes,state amount of deduction
q I
other county on property for
in Indiana?
❑Yes �1�io current year? Yes No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or o tract 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)t t is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
I 20 I 20 20 I 20 I 20
20 20 kCounty Date(mony, da year)
Signature of County AudillQr_we \�,� ` 21C lOZiI/We certify under the penalty of perjury thattt the above and foregoing information is true Bndd correct and that the applicant is rest ent of Indiana and
owner/contract buyer of th- aforementioned property on date application is filed.Si�l� /!n-- -
Date(month,day,year)
November 21,2022
Fu resi•-nt-••ress of applicant(number and street.city,state,and ZIP code)
504 N Main Street,Patoka,IN 47666-9516 $SO Date(month,day,year)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 G` November 21,2022
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.