HomeMy WebLinkAboutMortgage_Dewitt 4$. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
i_ _ FOR DEDUCTION FROM ASSESSED VALUATION
i State Form 43709(R12/6-14) 1 c"
Prescribed by Department of Local Government Finance I -, .f-
INSTRUCTIONS: File Mark
To be filed in person or by mail. A$by •, 1 l`- Form ft d with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the ded Lion is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is If County Auditor
located on or before January 5 of the immediately succeeding calendar year. 1/ 1 -.lt — ' ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the Coutrty--��4q�u Art ounty
where the property is located during the twelve(12)months before March 31 p�c(liyyee3rTp d 'prlhia,qug$.
See reverse side for additional instructions and qualifications. -`
Applicant(owner or contract buyer-see restrictions on reverse side)
Dewitt, Mellissa
Taxing District Key number/legal description Record number Page number
Owensville 26-18-07-101-000.247.022/PT NW 7-3-11 .20Ac /5-acot,
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,anent year March 1.current year date of application legal or eguita owner?
34,400.00 _ 0.00 46,428.00 es ❑ 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 prsperty in question:Annually Assessed
eal Property ❑ Annually Assessed
Mobile Home(IC 6-1A-7)
Name of mortgagee or contract seller
GVC Mortgage, Inc.
•
Address of mortgagee or contract seller(number and street,dry,state,and ZIP code)
One Plaza Dr., Suite 3, Pendleton, IN 46064
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 an If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes o current year? ❑Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction.
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
owner/contract buyer of the aforementioned property on date application is filed.
Signature(owner's full name) Date(month,day,year)
Full resident dress of applicant(number and street,city state,and ZIP code)
Person authorized by duty executed Power of Atomey 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)
7ha renahiee f r nad„n,ran:nnmda lmndcnnment r,n tn hvn and a half vaare and a fine not tn a'rpsd 4 in nnn - -. - - -