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HomeMy WebLinkAboutMortgage_Gish r,=•moo STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year i ., i ! FOR DEDUCTION FROM ASSESSED VALUATION ���� State Form 43709(R10/11-08) Prescribed by Department of Local Government Finance INSTRUCTIONS: ^2013 File Mark To be filed in person or by mail with the County Auditor of the county where the property is located. JUN 1 1 J Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. 2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months b re 31 of each year the deduction is sought. See reverse side for additional instructions and qualifications. GIa&ON COUNTY AUDITOR Applicant(owner or contract buyer-see restrictions on reverse side) Alvin L.Gish and Michelle L. Brown Taxing District Key number/legal description Record number Page numbe Princeton Township 26-12-18-302-002.110-028 /Pt SW 18-2-10 at), 3'o 7 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? 599,920.00 © 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 Nan that of applicant,indicate below: Is the property in question:Annually Assessed ©Real Property 0 Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Community State Bank of Southwester Indiana Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 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 ❑ Yes No ❑ 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/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 1 contract buyer of the aforementioned property on date application is fled. Signatur (owners full nam ) mt4.57 Date(month,day.year) Full resident addmis of applicant(number and street,city,state,and ZIP code) 1509 S.Main St.,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)