HomeMy WebLinkAboutMortgage_Barthel (2) It,-EQ. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
FOR DEDUCTION FROM ASSESSED VALUATION State Form 43709(R13/1046)
Prescribed by Department of Local Government Finance
I INSTRUCTIONS: !Fil- it a•
To be filed in person or by mail. Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. AA�� Z�nr1 pp�
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property�is 3 Lll1lyounty 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 the County Auditor of the coil
where the property is located during the twelve(12)months before March 31 of each year the deduction i- .g: ,��rfili
See reverse side for additional instructions and qualifications. GIBSON COUNT
Applicant(owner or contract buyer-see restrictions on reverse side) Y/1�DIrOFj
Christopher S Barthel and Melissa R Barthel
Taxing District Key number/legal description Record number Page number
Johnson 26-22-12-300-002.254-024 A o i to Li698
Accessed value of real property as of Mortgage/Contract indebtedness unpaid as of 'Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
154,500.00 ❑ Yes ❑ No
It 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
,4 Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
GVC Mortgage, Inc., ISAOA
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) I I
1420 N Weinbach Ave. Evansville, IN 47711
Name of assignee or other owner or holder of mortgage I ��/ I
Address of assignee(number and street.city,state.and ZIP code) I n� ��� Lmountofdeducuon
Does applicant own property in any It yes,what county? Wnat Taxing District? Has t
other county on pr, I
in Indiana? ❑Yes ❑No tune
A person is not entitled to this deduction unless the person has a balance on the person's mo recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county record aion.
COUNTY AUDITOR I
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,year)
I 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 a me V v l` �"-k Y Date(month,day,year)
I/` lQV \l\/
Full resident address of applicant(number and street,city,state,and ZIP code)
1302 West Cloverdale Court, Haubstadt, IN 47639 -
1 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 two and a half years and a fine not to exceed S10,000.