HomeMy WebLinkAboutMortgage_Kidd e STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township I Year
. -:.; FOR DEDUCTION FROM ASSESSED VALUATION
n State Form 43709(R12/m-14) GI on Owensville 2016 FIL n Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be filed in person or by mad. �q��t��� Form toed with
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which dr4ctBn w.wught.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is gi.County Auditor
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 t Co r of the county
where the property is located during the twelve(12)months before March 31 udion i sought.
See reverse side for additional instructions and qualifications. GIBSON COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Brandon L Kidd
Taxing District Key number/legal description Recto number P number
Owensville 26-18-06-303-000.725-022 I jis Page 3 e
r ssessed value d real property as of Mortgage/Contact indebtedness unpaid as d Mortgage/Contactt indebtedness unpaid as of Is the applicant the site
March 1,current year March 1,current year date d application legal or equi ble owneR
133,200 124,800 p yes ❑ No
If nc,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
2 ) Real Property ❑ Annually Assessed
Mobile Hone(IC 6-1.1-7)
Name of mortgagee or contract seller
Fifth Third Mortgage
Address of mortgagee or contract seller(number end street,city,state,and ZIP code)
5001 Kingsley Dr., Cincinnati, OH 45227
IName of assignee or other owner or holder of mortgage
Address of assignee(number and street,dry,state,and ZIP code)
Does applicant own property in a If yes,what county? Wnat Taxing District? Has this deduction been requested If yes,sate 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.
I COUNTY AUDITOR
Deduction approved in the amount of:
20 /I 20 I 20 20 20_ 20 20
Signets,a ounty Auditor / / CD0 ` County Date(month,day,year)
1 I/We certify under the penalty of perjury that the above and foregoing information is true and correct and e applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
Sign (owner's Na name)' � � Date(month,day, art
resident address of applicant(number and street.thy state,and ZIP code)
108 Rock Rd., Owensville, IN 47665
Person authorized by duly executed Power oAttomey or by IC 6-1.1-12-0.7 Date(month,day,yeah
IAddress of authorized person (number and street.city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a haft years and a fine not to exceed$10,000.