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HomeMy WebLinkAboutMortgage_Messick • /: Yno STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year fde FOR DEDUCTION FROM ASSESSED VALUATION M State Form 43709(R12/6-14) • m,Prescribed by Department of Local Government Finance INSTRUCTIONS: F IF F ea'+l�Maw! D To be filed in person or by mail. Filing Dates: 1) Real Properly:Must be completed and dated in the calendar year for which the deduction is sought. Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is El g4Cppo'unty Auditor located on or before January 5 of the immediately succeeding calendar year. „FEB 1[$ OON7y Recorder 2) Mobile/Manufactured Homes 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. �//J Applicant(owner or contract buyer-see restrictions on reverse side) T•Y Keith A Messick GIBSON COUNTY AUDITOR Taxing District I Key umber/ al description Re bee Page nu er Center r c i 3 a©- app- 001.604- �.l Ce Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indeb edness unpaid as of Is the applicant the sole March 1,current year March 1,current year date of application legal or equitable owner? 127,500.00 p Yes ❑ No If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom I If name on record is dtterent than that of applicant,indicate below: Is the property in question:Annually Assessed O Real Property ❑ Annually Accessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Cartus Home Loans Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 1 Mortgage Way Mount Laurel, NJ 08054 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 If yes,state amount of deduction other county on property for in Indiana? ❑Yes 17 No current year? ❑Yes 17 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 aforementioned property on date application is filed. Signature o nens fu0 name) , C . Date(month.day year) X11, i r I I it i • �A _.. • . Full res rent address of a••icant( umber and street.city state,and ZIP code) 1897 South Lakewood Circle, Francisco, IN 47649 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 street,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.