HomeMy WebLinkAboutMortgage_Gries (4) os n”n4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
e s FOR DEDUCTION FROM ASSESSED VALUATION 51 2014
6 State Form 43709(R71 16-09)
\i rsi� 2' Prescribed by Department of Local Government Finance F I 1 E t Mark
INSTRUCTIONS:
To be filled in person or by mail. Form filed with:
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is soudllE C 3 0 2114 ❑
Must be filed with the County Auditor or County Recorder of the county where the property is b caa{ed County 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.1 e 4
county where the property is located during the twelve(12)months before March 31 of each yea I.• yrtll►ii
deduction is sought. GIBSON COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Donald E. Cries and Debra R. Cries
Taxing District Key number/legal description /19 E 925 S. Haubstadt, Indiana 47639 Record number Page number
_ 1-
2/K- o-1•" 26 - 19. 30 - ciao - oob. 4go - 0 d3 /1-1-5-008
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?
$60,000.00 a 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
O Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Diamond Valley Federal Credit Union
Address of mortgagee or contract seller(number and street.city,state and ZIP code)
840 E. Diamond Avenue, Evansville, IN 47711
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 O No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20_ 20 20 20
Siggnaatturr000ffCounty Auditor c- County Date(month,day,year)
I/We certify nenalty of perjury 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.
Zresid ature(o e f 11 1i (number Date(month,day,year)
if en d ess if and street,city,state,a ZIP code)
19 E 925 S, Haubstadt, IN 47639
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)