HomeMy WebLinkAboutMortgage_Wilson (8)�• r?o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
;°a.,_, . 4 FOR DEDUCTION FROM ASSESSED VALUATION
-� �� State Fortn 43709 (R17 / 6-09) Gib50n Ft. BfanCh 2013
•��' ;,;; J• Prescribed by Depanment of Local Govemment Finance
FIIB
., INSTRUCTIONS:
be filed in person or by mail. �� �
�vg Dates: i) Real Property: Must be completed and dafed in the calendar year tor which the deduction is sought. AP 9�O�unry Auditor
Must be (led with the CountyAuditor or County Recorder of the county where the property is located
on or be7ore January 5 0/ [he immediately succeeding calendar year. County Recorder
2J Mobile /Manufacfured Homes not assessed as Real Property: Musf �le with the CountyAUditor ot the C ,
counfy where fhe property is located dunng fhe twelve (72) monfhs betore March 37 oi each year fhe - \
deduction is sought. U
See 2verse side for additional instructions and quali�cations. GIBSON COUNTY AUDITOR
Applicant (owner or wnUaU buyer - see restncfions on reverse side)
Ruth A. Wilson
Taxing Distnct Key number / legal description Record number Page number
Ft Branch TWP 26-t&13-404-000.019-026 ao�a � �
hssessed value of real property as of Mortgage / Contract indebtedness unpaid as of Mortgage / Contract indebtedness unpaid as of I5 the applicant the sole
Ma¢h 7. wrrent yrar March t, curtent year date of application legal or equitable owner?
84,200 81,530 � Yes ❑ No
If no. what is his / her euct 5hare of interest? If owned with someone oIDer Nan spouse, intlirate with whom
It name on record is diRerem ihan ihat of appliwnt, indicate below: Is the property in question: Mnualtylicussed
❑� Real Property ❑ Mnually Pssessed
Mobile Home (IC 67.1-7)
Name of mortgagee or contrect seller
Fifth Third Mortgage Company
Atldress of mortgagee or mnVacl seller (numberand sfreet, ury, stafe, and ZIP coda)
5001 Kingsley Dr. MD: 1 MOCBQ, Cincinnati, OH 45227
Name of auignee or other owner or holder of rtangage
Address of assignee (number end sfreef. uty, state. and ZIP code)
noes applirant own property in any oNer II yes, what counry? �.ction been requested on property
mty in Indiana? �
❑ Yes O No ❑ Yes ❑ No
� %
COUNTY AUDITOi., �
Deduction appmve0 in the amount of: /
20 _ 20 20 20 20 _\ 20 20
Signature o( CounryAUditor Counry Date (month, day, yea�
I I We certify under the penalry of perjury ihat the above and foregoing infortnation is We and correct and that the applicant is a resident of Indiana and
owner / conVact buyer of the aforementioned property on date application is filed.
Signature (owners INI name) Date (monih, day, yea�
1G�/L 04I03/2072
Full residem address of applicant (number an0 sfreeG dty, state, and ZIP code)
204 N. Elm Street, Ft. Branch, IN 47648
Permn authorized by duy e:ewted Power of Attomey or by IC 67.7-12-0J Da:e (month, day, yea�
Atldress of aulhonzed person (numberand slreet, ury, sfafe, and ZIP code)