HomeMy WebLinkAboutMortgage_Skelton STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
eE it FOR DEDUCTION FROM ASSESSED VALUATION
S State Form 43709(R12/6-14)
Prescribed by Department of Local Government Finance 2_ `MI'(
Fie Maji'
INSTRUCTIONS:
To be filed 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 sought. 11A�II II r(� 6 , 0p County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the pro y�s
located 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 of the z. my
where the property is located during the twelve(12)months before March 31 of each year the deducti•, ,)
i• •`P/a xl(1-a;
See reverse side for additional instructions and qualifications. GIBBON COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Skelton, Larry
Taxing District Key number/legal description Record number Page number
Columbia 26-14-29-100-000.868-006/Pt N NW 29-2-8 1 Ac .o lS — 33 aW
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?
180,800 0.00 152,714.00 Yes ❑ No
If no,what is his I her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is deferent than that of applicant,indicate below: Is the property in question:Annually Assessed
CXReal Property ❑ Annually Assessed
-'T Mobile Home(IC 6-1.1-7)
Name of mortgagee or contact seller
GVC Mortgage, Inc., ISAOA
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 District? on Has this dteduuction been requested If yes,state amount of deduction
other county current year? ❑Yes ❑No
in Indiana? ❑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/aforementioneeedd property on date application is filed.
Signature(owner's e6�is��rl Date(month,day,year)
`y\/ X /� �D�j
Full resident a ss of applicant(number and street,city.state,and ZIP code) `'
Person authorized by duly executed Power of Attomey or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and sheet.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.