HomeMy WebLinkAboutMortgage_Stewart Itin STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R11/6-09) GIBSON PATOKA 2015
=.4 t Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail.
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.F
Fo filed
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Must be tiled with the County Auditor or County Recorder of the county where the property is located County Auditor
on or before January 5 of the immediately succeeding calendar year. ❑ Citify Recorder
2) Mobile/Manufactured Homes not assessed as Real Property.Must file with the County Auditor of the CT 1
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought
See reverse side for additional instructions and qualifications. �nj, u
Applicant(owner or contract buyer-see restrictions on reverse side) GIBSON COUNTY AUDITOR
Levi Mark Stewart and Krystal Marie Stewart
Taxing District Key number/legal description gulp nym¢er Pagf rL be
Patoka 26-11-15-300-004.369-027 '(�/r(`//J� 1 C.. I� ,
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of s the applican the sole
March 1.current year March 1,current year date of application legal or equitable owner?
26,300 160,643.19 160,000 O Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
1 If name on recce is difrerent than that of applicant,indicate below Its the property in question:Annually Assessed.
Si Real Property ❑Annua0y Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
First National Bank of Carmi
Address of mortgagee or contract seller(number and street.city,state.and ZIP code)
201 E.Main St.Carmi, IL 62821
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,qty,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?
- , c ❑ Yes 0 No . • - - -� ❑ Yes GI 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 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 aforemention d property on date application is filed.
Signature(owners name A ^ wit— Date(month,day,year)
5
\F.)L,LJ`u �\..YC yC(lYr, 09-25-15
Fug resident address of applicant(number and s ,city, e,,and ZIP code)
lfl(0 S , 3� l .� �Irlile_94 �l11 I k1Li 7e7)
Person authorized by duty 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) -
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