HomeMy WebLinkAboutMortgage_Jessup ' dy-"•a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township Year
4. _ _ ; FOR DEDUCTION FROM ASSESSED VALUATION I
State Form 43709(R71 l 6-09) Gibson F' I tokk� �14
c Prescribed by Department of Local Government Finance —
INSTRUCTIONS:
To be filed in person or by mail. Fo{�l�I�d rth:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. �`(L{ 1 2013
Must be filed with the County Auditor or County Recorder of the county where the property is located / County Auditor
�LJ
on or before January 5 of the immediately succeeding calendar year. If . C lnt er
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 theGIBSON COUNTY AUDITOR
deduction is sought.
See reverse side for additional instructions and qualifications. •
Applicant(owner or contract buyer-see restrictions on reverse side)
Amy B.Jessup '
Taxing District Key number/legal description Record number Pag$pgtpyt0lont
Gibson 2-11-13-202-001.141-027&26-11-13-202-001.143-027 20130000290?
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,current year March 1,current year date of application legal or equitable owner?
141,900.00 0.00 151,920.00 GI Yes ❑ No
If no,what is his/her exact share of interest? If owned yith someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
TA 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.end 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? 0 Yes ❑ No Vanderburgh for current year? ❑ Yes GI No
COUNTY AUDITOR
Deduction approved in the amount of
20 20 20 20 20 20 20_
Signature of County Auditor I County Date(month,day,year)
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
o er/contract buyer of the aforementioned property on date application is filed.
Xi. .le(owner' name) Date(month,day,year)
,(()� 4/25/2013
Full residen - dress o plicant(numbe and street,city,state,and ZIP code)
704 Park Avenue W.,Princeton, IN 47670
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 I Date(month.day,year)
Address of authorized person (number and street,city,state,and ZIP code)