HomeMy WebLinkAboutMortgage_Winget df A STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
e. FOR DEDUCTION FROM ASSESSED VALUATION
, State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
INSTRUCTIONS:
File Mark
To be(led in person or by mail. Form fl the
Filing Dates: 1) Real Property:Must be completed and dated in the calendar y for uc non rs sought. County Auditor
Must be filed with the County Auditor or County Recorder of the county where the property is located
on or before January 5 of the immediately succeeding calendar year. e[p Q '� ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must 772 With e.9(I
Mtjtuditor 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.
Applicant(owner or contract buyer-see restrictions on reverse side) GIBSON COUNTY AUDITOR
BRANDI M WINGET
Taxing District Key number/legal description Record number gal,
r 1Pnumber
I
FT BRANCH 26-19-18-101-001.001-026
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?
175,300 201,465 201,465 GI 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 below: Is the property in question:Annually Assessed
Real Property ❑Annually As"Pssed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract sever
GVC MORTGAGE INC
Address of mortgagee or contract sever(number and street,city,state.and ZIP code)
ONE PLAZA DRIVE, SUITE 3, PENDLETON IN 46064
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,a 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 No ❑ yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 I 20 20
Signatur f aunty Auditor County Date(niesth.da ,year)
II 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.
Sign owner's rue name) pa' (month,day,year)
`SLC$, e;L c` -v l� k `�31 :,.
Full resident address of applicant(number and street,city,state,ImaZIP code)
901 MOHAWK DRIVE,FORT BRANCH,IN 47648
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)