HomeMy WebLinkAboutMortgage_Jones (2) • STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�4 "' o County Township Year•FOR DEDUCTION FROM ASSESSED VALUATION 1
State Form 43709(R13/10-15)
2018
"s J Prescribed by Department of Local Government Finance M
lam
INSTRUCTIONS:
F IT To be filled 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.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the JR 2 2018
property is located on or before January 5 of the immediately succeeding calendar year. County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor of the ❑ County CoZ,Recorder
county where the property is located during the twelve(12)months before March 31 of each year the ami:4
deduction is sought.
See reverse side for additional instructions and qualifications. G I BSO N COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
David Michael Jones and Delores Darlene Jones
Taxing District Key number/legal description 26-23-06-200-000.890.009/517 S 9th Regard n��umberO Page number
Ave., Haubstadt, Indiana 47639 I -""d51
Assessed 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?
$129,600.00 ❑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 t property in question: Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7) _
Name of mortgagee or contract seller
New Penn Financial LLC
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4000 Chemical Rd, Suite 200, Plymouth Meeting, PA 19462
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
other county / on property for deduction
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)
1/We certify under 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 contract buyer of the aforementioned property on date application is filed.
Signature(owner's full nam`p'J 1 \,� 1� /� Date(month,day,year) �1a �+�
LL 1i1itPikp K1A_OJ1lJLI O.v11 N \fSL� 1)IF 0. 6(LN[I,Otmcv Oa {trim 0 dcl�� b
Full resident addre- o applica I(number and treet,city,state, an ZIP code) 111
517 S 9th Ave.,Haubstadt, IN 47639
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 Iwo and a half years and a fine not to exceed S10,000.