HomeMy WebLinkAboutMortgage_Deal '. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coin Township Year
e4.: `—= FOR DEDUCTION FROM ASSESSED VALUATION
tl� State Form 43709(RIO/11-08) Gibson•‘1';,, It Prescribed by Department of Local Government Finance I .111 _
INSTRUCTIONS: il:j Mi _.'
To be tiled in person or by mail with the County Auditor of the county where the property is located. CC r��. 1-�1��11 nn ff 1
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. ActLLr'fXKea�year
2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months befor
the deduction is sought.
See reverse side for additional instructions and qualifications.
GIBSO ,OUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Travas Deal and Sandra Deal
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Taxing District Key number 1200 description I gamgAUp+pa� P lie n bqX�
Johnson 26-23-07-200-002.124-024/Pt of the NE Otr.of Sec.7,township 4 S /—^,��(( ''yY`���� rte/ _1`
Assessed value of real property as of 'Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant e sole
March 1,current year March 1,current year date of application I legal or equitable owner?
5290,106.00 El Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
I
If name on record is different than that of applicant,indicate below: Is thelproperty in question:Annually Assessed
El Real Property ❑Annually Assessed
I Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Fifth Third Mortgage
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
5001 Kingsley Dr.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? Has this deduction been requested on property
county in Indiana? for current year?
❑ Yes No I I:1 Yes ❑ No
I
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 I 20 20_
Signature of County Auditor County Date(month,day,year)
I/We certify under the p alty of perjury th- the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
own ntract buyer of e aforementio•-• •roperty on date application is filed.
' natu es ha name) � I Date(month,day,year)
41 CIA, L.E.. /Pi -s-/j
Full resident address of applicant(number and street city,state,and ZIP code) •
373 E.Hirsch Woods Ln. Haubstadt, IN 47639
a
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 I Date(month,day,year)
i
Address of authorized person (number and street.city,state,and ZIP code) I
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