HomeMy WebLinkAboutMortgage_Collman ..• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION Gibson Patoka 2022
State Form 43709(R14/1-20)
t :
0Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail. 16 S M I f SI
F rrrr 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. ounty Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Hannah N.Coltman and Mark D.Boyd
Taxing District Patoka
Assessed value of real property as of
Key number/legal description Record number P u
mber
26-12-07-304-000.726-028/Pt SW 7-2-10,Parcel ID(s): 2-2-26-12-07-304-000.726-028
Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant pl able owner?
assessment date,current year assessment date,current year date of application$0.00 $156,565.00egal or I�Yes CI No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
number
name on record is different than that of applicant,indicate below:
Is the roperty In question:Annually Assessed
Real Property CI Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Mortgage Masters of Indiana,Inc. ISAOA FILED
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
501 N.Cross Pointe Blvd.,Evansville,IN 47715 DEC 2 7 2022
Name of assignee or other owner or holder of mortgage Address of assignee(number and street,city,state,and ZIP code) / /c-
Does applicant own property in ajy If yes,what county? What Taxing District? i, ction n requested If yes,state amount of deduction
other county •L •.. on propel for Yes El No
in Indiana? ❑Yes No I current year?
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or cont t 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 is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of Counl)(Auditor County Date(month,day,year)
/�} � � Gibson /r/ -7/..
I I We certify under penalty of perjury that the above and foregoing InformationI is true and correct and that the applicant Is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application
Data Tenth,day,year)
_tigrea (owrrers ciamrJCnU .(/i \2/7.O / G22
Full
resident address of app scant(number and streeoRki
ity,state,and ZIP code)
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)
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
Amount of indebtedness
$156,565.00
Name of applicant Name of mortgagee or contract seller
Hannah N.Collman and Mark D.Boyd Mortgage Masters of Indiana,Inc. ISAOA
Date filed(month,day,year) Taxing District
Patoka
Key number/legal description
26-12-07-304-000.726-028/Pt SW 7-2-10,Parcel ID(s):26-12-07-304-000.726 028 Date( nth rear)
Slgn@ �of County Audit�r�nty Recorder County ��!d 7I a
// ��� -. �/ Gibson