HomeMy WebLinkAboutMortgage_Garris . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
qq , ' State Form 43709(R13/10-15) bson tgomery 2018
S,,p j Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail. 2[ 0 2018 Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is k t. ,��
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is L7 County 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 Au -erif ti
where the property is located during the twelve(12)months before March 31 of each y tj upljj I • -
See reverse side for additional instructions and qualifications. (Gi1ICGSS 'J' -r
Applicant(owner or contract buyer-see restrictions on reverse side)
Brad S. Garris and Heather M. Garris
Taxing District Key number/legal description Record number nuyy�r
Montgomery 26-17-03-300-000.116-021 9-C? L r (g7,3
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
aswssment date,current year assessment date,current year date of application legal or equitable owner?
156,500 168,785 TO 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
17) Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Midland Mortgage Corporation
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
25 Cumberland Street, Suite 120, Fort Wayne, IN 46825
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state.and ZIP code)
Does applicant ap own property in ny If yes,what county? What Taxing District? Has this duction been requested If yes,state amount of deduction
on property for ❑No
in Indiana? ❑Yes No current ear? ❑Yes
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/contract buyer of the aforementioned property on date application is filed.
S ture(owner's hull name) Dat on h,day,rear)
of / / thud?44 _/)anrv-a I I LI II d'
Fat rns dent address of applicant(number and street,city,stale,and ZIP code)
q1 30 W 5 i-o k Qcnd j(,6, O c e l e n s v i I t t, Snl 47445-
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,yeas)
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.