HomeMy WebLinkAboutMortgage_Dewig (2) ,..moo STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
°e FOR DEDUCTION FROM ASSESSED VALUATION
State Foam 43709(R12/6-14)
,` Prescribed by Department of Local Government Finance
1.1-1I : ,
INSTRUCTIONS: F r
To be filed in person or by mail. r�-nm with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought • ttl���III
Must be filed or postmarked with the County Auditor or County Recorder of the county where the propef4 Js n n rt County Auditor
located on or before January 5 of the immediately succeeding calendar year. JJ UU�IVV 6 •7 County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county
where the property is located during the twelve(12)months before March 31 of each year the deduction• sought.
See reverse side for additional instructions and qualifications. ,//�- j 4rrpj°
Applicant(owner or contract buyer-see restrictions on reverse side) GIBSON COUNTY AUDITOR
Dewig, Jan M.
Taxing District Key number/legal description Record number Page number
Ft. Branch 26-19-18-303-000.515-026/Waters ADD 332 Pt Amoka.la
Assessed value of real property as of Mortgage I 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?
48,900.00 54,150.00 70,421.00 `I1 ds ❑ 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 dCerent than that of applicant,indicate below: Is the property in question:Annually Assessed
deal Property ❑ Annually AscPssed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contact seller
GVC Mortgage, Inc.
Address of mortgagee or contract seller(number and street,city,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 any If yes,what county? What Taxing Dismct? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes , No 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 IWe 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 I contract buyer of the aforementioned property on date application is filed.
Signatur nets full name) Date(mom ,day,yeade
Full resi t address of applicant(number and sheet,city,st. d ZIP code)
Person authorized by duly executed Power of AGOmey 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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.