Loading...
HomeMy WebLinkAboutMortgage_Schmitt (2) ItSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year : FOR DEDUCTION FROM ASSESSED VALUATION F i g I' State Form 43709(R10/11-08) JLA J •. ---,; i---4T; i", Presented by Department of Local Government Finance I INSTRUCTIONS: NOV 2 7 2013 File Mark To be filed in person or by mail with the County Auditor of the county where the property is located. 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,MClyee ? ap -baf5 a March 31 of each year the deduction is sought. 7SWI GIBSON COUNTY AUDITOR See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Jeremy Schmitt Taxing District Key number I legal description - Record number Page number Ft Branch Township 26-18-13-403-000.723-026 I 13- (p 3 CD Assessed value of real property as of Mortgage/Contract'indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole March 1,current year March 1,current year date of application I legal or equitable Amer? 71,400.00 tiz36666 (dl, 7CO•°0 © 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 13 Real Property ❑Annually Assessed I Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Fifth Third Mortgage Company Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 5001Kinglsey Drive,Cincinnati,OH 45227 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? lies this deduction been requested on property county in Indiana? for current year? 1:1 Yes 12 No I ❑ yes ID No I COUNTY AUDITOR Deduction approved in the amount of: 20 20 20 20 20 20 20 Signature of County Auditor 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/contract buyer of the aforementioned property on date application is filed. igna (owner's full name X Date(month,,day, year) —� dr .11/25/13 ua res'•- t address of applicant(number and street,city,state,and ZIP code) 307 W.Vine Street, Ft.Branch, IN 47648 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) I