HomeMy WebLinkAboutMortgage_Parker (2) fr
Pa\ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
e� 4
µ w FOR DEDUCTION FROM ASSESSED VALUATION
I• State Form 43709(R11 /6-14) 2015
•. Prescribed by Department of Local Government Finance File Mark
m,a T T
INSTRUCTIONS: T!T L
To be filled in person or by mail. ��-hl Y F with:
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is so t.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the ❑ County Auditor
property is located on or before January 5 of the immediately succeeding calendar year. AUG 2 5 gib County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor of th€
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought. Jn'�a^
See reverse side for additional instructions and qualifications. fte
Applicant(owner or contract buyer-see restrictions on reverse side) GIBBON COUNTY AU DTI VIA
Danny Ray Parker,Jr. and Ashley Jeane Parker
Taxing District Key number/legal description 26-18-36-300-001.966-024/1285 W Chukar 7. 157/13„,
Holw, Haubstadt, Indiana 47639 U
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?
$272,000.00 ( 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
eat Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Top Flite Financial, Inc. and or their warehouse lender
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
123 E Grand River Ave,Williamston, MI 48895
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? Has this deduction been requested tf yes,state amount of
other county on property for deduction
in Indiana? ❑ Yes .WNo current year? ❑ 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 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.
■
$igrlat� s f me Vale(month,day,year)
J / yhll )
Full re • a.< s o apph nt tuber and street,city,state,and ZIP code)
s - ar Holw, 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)
The penalties for perjury can include imprisonment up to Iwo and a half years and a fine not to exceed$10,000.