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HomeMy WebLinkAboutMortgage_Nole a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou • I Township Year E.�, ; FOR DEDUCTION FROM ASSESSED VALUATION ? • i °• State Form E3709(R10/11-08) gibso it i , Rt• a • � Prescribed by Department of Local Government Finance D. I INSTRUCTIONS: JULFHONP 014 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 twelve(12)months be March ar the deduction is sought. W�{Cgjlill See reverse side for additional instructions and qualifications. GIBSON COUNTY AUDITOR Applicant(owner or contract buyer-see restrictions on reverse side) James Tracy Nole and Judith A.Note Taxing Gibson number legal R�cptSiti P Gibson 26-11-14-102-000.705-027 Columbia Est 3 (r,J�r/l/.\1 I if Assessed value of real properly as of Mortgage/Conaaa indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the prttant the sole March 1,current year March 1,current year date of application legal or equitable owner? 103,750.00 © Yes El 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 ©Real Property ❑Annually Assessed 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,sate.and ZIP code) 5001 Kingsley 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? 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 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 ow -r/contract buyer of the aforementioned property on date application is filed. ••nature' • els lull name) }..... .5:27, Date I(month,day,year) a c `�s. to -a-1, -a6l Li Fu resident:•dress of applicant(number and street.city state,and ZIP code) • 63 W. •lumbia Est,Princeton, IN 47670 Per , au • . ed by duly executed Paver 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)