HomeMy WebLinkAboutMortgage_Miller (14) 0=-1,44 STATEMENT OF MORTGAGE OR CONTRACT I 4E®NE
d/ ` IIII/I������ ��....// C unty Township Year
- . t FOR DEDUCTION FROM ASSESSED VALUATIO to-
' State-Form 43709(R12/6-14)
'• .'' Prescribed by Department of Local Government Finance OCT 15 ZO'c
INSTRUCTIONS: J File Mark
To be filed in person or by mail. Form riled ith:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar yp�d(�,,((o,,((w�' % -t.riir,11 yis sought.
Must be filed or postmarked with the County Auditor or Count? J?lbNbciiao. ,, nr/- - the property is County Auditor
located on or before January 5 of the immediately succeeding calendar year. • a ITOR ❑ County Recorder
2) Mobile/Manufactured Nomes 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 is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restdcdons on reverse side)
Miller, Kenneth J.
Taxing District Key number/legal description Record number Page number
Ft Branch 26-18-24-202-000-719-026/PT NE 24-3-11 .12 AC / 5 q 3 6 7
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
March 1,anent year March 1,current year date of application legal or equitable owner?
75,100.00 70,400.00 68,174.00 a-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
,Real Property ❑ Annualy Assessed
Mobile Home(IC 6-I.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 Drive, Suite 3 Pendleton, IN 46064 _ __ _
Name of assignee or other owner or holder of mortgage /y7/y� �� (y�� 1�
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 di /5- l- b iJ
other county / on propert
in Indiana? ❑Yes Ico current ye:
A person is not entitled to this deduction unless the person has a balance on the person's mortgag
recorder's office(including any home equity line of credit that is recorded in the county recorder's t
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of un Auditor County Date(month,day,KM / _
JQAAJ 1/We certify under the penalty of perjury that the above nd foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/c ract buyer of the aforementioned roperty on date application is filed.
3gcpatu2 nets tug e) Date(month,day,year)
F reside tad ress of a cant(numb and street,city,state,and ZIP code) I
--- 64 k%;b tiro i„k iera-.,l . Cr/ �tI4.1cIn ;11/ 247‘
Person authorized by duly executed Power of Attorney or by IC6-1.1-12-0.7 'Date(month,day,year)
Address of authorized person (number and street,dty 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.