HomeMy WebLinkAboutMortgage_Burton (3) Al, EMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS I County I Township I Year
� . .. FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(Rit/6-09) Gibso I at I 2014
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` � Prescribed by Department of Local Government Finance
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INSTRUCTIONS: + 1F-L �,
To be filed in person or by mail. Form rued with:
Filing Dates: t) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. t U6 6.0upt 9
Must be filed with the County Auditor or County Recorder of the county where the property is located y Auditor
on or before January 5 of the immediately succeeding calendar year. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the p,,
county where the property is located during the twelve(12)months before March 31 of each yearrjhe -'•tv�• -�jq►^�
deduction is sought. UIBSON COUNT
See reverse side for additional instructions and qualifications. Y AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Christopher A.Burton
Taxing District Key number/legal description Record number Page numbe'
Gibson 26-12_15-200_001.205-027 I 00i 3 I l 6 i3
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Maids L current year March 1,current year date of application legal or equitable owner?
139,200.00 140,000.00 146,788.00 GI Yes ❑ No
If no,what is his/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 below. 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 otner If yes.what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑
Yes 0 No GI Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor I County I 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/ •ntract bu er of the aforementioned property on date application is filed.
gnat;'- owrle lull ame) l� Date(month.day,year)
1
(�/f/ 8/12/2013
F•.resident.. ress of applicant(number and street,city,state,and ZIP code)
3211 E.Top Hat Road,Princeton, IN 47670
I Person authorized by duty 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)