HomeMy WebLinkAboutMortgage_Gulledge (2) ^•n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
L%\ FOR DEDUCTION FROM ASSESSED VALUATION
Stator rite 43709 par/6-14) FILED
;,,, �' Prescribed by Department of Local Government Finance
INSTRUCTIONS: rc
To be filed in person or by mail. rf t o raffled with:
Filing Dates: 1) Real Property Must be completed and dated in the calendar year for which the deduction is sought. SE P 1 U i f
. Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. It! .. Recorder
2) Mobile/Manufactured Homes not assessed as Real Property Must tile with the County Auditor of the.4 t • q)tlH
where the property is located during the twelve(12)months before Mach 31 of each year the deduction • :..y.
See reverse side for additional instructions and qualifications. G1ocfN C . UNTV AUDITOR
Apprrant(owner or contract buyer-see restrict/ons on reverse side)
Cory E. Gulledge and Media R. Gulledge
Taxing District Key number/legal description Record number Page number
Columbia 26-13-12-200-000.003-006 a0 Cl -3111
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1.anew year March 1,current year date of application legal or equitable owner?
161,029.00 p 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 different than that of applicant,indicate below: Is the property in question:Annually Assessed
0 Real Properly ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
myCUMortgage, LLC
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
3560 Pentagon Blvd. Suite 301, Beavercreek, OH 45431
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 o0 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/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 afo entioned property on date application is filed.
nature(o en's lull name) Date(month,day,year)
Full resident address of applicant(nu rend street,c' , le.end ZIP code)
11398 E. Base Rd, Oakland City, IN 47660
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.