HomeMy WebLinkAboutMortgage_Briggs (2) h_'%"> STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
cti FOR DEDUCTION FROM ASSESSED VALUATION
State Pore 43709(R13 m/10-15)
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\` Prescribed by Department of Local Government Finance
INSTRUCTIONS:
To be filed in person or by mail. 2 filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. JUN 2 1 LWJ
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is LJ County Auditor
located on or before January 5 of the immediately succeeding calendar year. • • •• Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the tt •
where the property is located during the twelve(12)months before March 31 of each year the deduction P %+
See reverse side for additional instructions and qualifications. GIBSON COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Briggs, David J. & Loretta A.
Taxing District Key number/legal description fi€cc�ryrryr, ge b�r/�
26-14-19-101-000-815.007/Tr Add 10 Pt Blk 15 (�/�f fJ��'`\ Jl ((l((
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the appli the sole
assessment date,current year assessment date,current year date of application legal or eq able owner?
55,100 81,611 86,316 Yes ❑ No
If no,what is his I her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is dfferent than that of applicant,indicate below: Is th roperty in question:Annually Assessed
eal Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Guaranty Trust Company
Address of mortgagee or contract seller(number and street.city state.and ZIP code)
316 Robert Rose Dr., Murfreesboro, TN 37129
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 y If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other 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.
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 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 contra buyer of the aforementioned property on date application is filed.
Signature(pion s tuff hame)O it X tttate(month,day,year)
X 114 6�1c
II resident address of apphcan (r rm r and s et,city,state,and ZIP code)
t.i'tfwSL,ec ST oAkLAvc) C,T1 kKJOIA*41t 'i76GO
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$10.000.