HomeMy WebLinkAboutMortgage_Beach (5) / a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township Year
!t$ FOR DEDUCTION FROM ASSESSED VALUATION
s'• State Form 43709(RU/6-09) Gibson Princeton 2014
I 1.� Prescribed by Department of Local Government Finance
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INSTRUCTIONS:
•To be filed in person or by mail. F - d,. It
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed with the County Auditor or County Recorder of the county where the property is located ❑ Coun Audi9r0
on or before January 5 of the immediately succeeding calendar year. M 6Co corder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the .
county where the property is located during the twelve(12)months before March 31 of each year the /�
deduction is sought. )//�_-.
See reverse side for additional instructions and qualifications. GIBSON COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Travis C. Beach
Taxing District Key number/legal description Record number I Page m r
Gibson 26-12-07-304-000.130-028 • �ns rumen:
oat znnnn3z7,3
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,anent year March 1,current year date of application legal or equitable owner?
90,700.00 70,000.00 65,204.00 O Yes ❑ No __
If no what is his I 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 belay... Is the property in question:Annually Assessed
IS Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Hallmark Home Mortgage,LLC
Address of mortgagee or contract seller(number and street.city,state.and ZIP code)
7421 Coldwater Road,Fort Wayne, IN 46825
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street.city,state.and ZIP code)
Does applicant own property in any other If yes.what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑ yes 0 No ❑ yes 0 No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,year)
I I We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
nature efs full name)
g ) �� Date(month.day,year)
) - C rte/Cis 4/75/2073
9'Full resident address of applicant(number end street,city,state,and ZIP code)
748 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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