HomeMy WebLinkAboutMortgage_Foster (7) a ork, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
c,,,Arfr<A'':::CA FOR DEDUCTION FROM ASSESSED VALUATION
,i State Form 43709(R12/6-14)
Prescribed by Department of Local Government ent Finance
INSTRUCTIONS: File Mark
To be filed In person or by mail. Form need with:
Filing Dates- 1) Real Property:Must be completed and dated in the calendar year for which the deduction Is sought
Must be filed orpostmarked 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 suaceedng calendar year. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county
where the property Is located during the twelve(12)months before March 31 of each year the deduction Is sought
See reverse side for additional Instructions and qualifications .
Applicant(owner or contract buyer-see restrictions on reverse site)
(otey J. Foster anJ MeliSSol R• Foster
Taxing District Key number/legal desoripton Recoil number Page number
z6 -I °I -I °I -sot - 000.5'11- 026 / a3f398
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of b the
Mardi 1,current year Merck i,eunent Year date of ..�..:,.n D� aDPOij b die ede -
� :-'! w legal or equ ble ownen
,ta-•�.;kir;.e�.>.. 6 S, 200.00 es ❑ 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. te party h question:Annually Assessed
Real Property ❑ Anni yAxe ad
Name of mortgagee or contract seller Mobile Noma(IC 61.1-T)
I
German AmtriCan goocorr r
Address of mortgagee or contract seller(number and street city,state,and ZIP code)
JUL 2 552018
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) >J 444—4;a,+4r
GIBSON COUNTY AUDITOR
Does applicant own In any If yes,whet county? What Taxing-District? Has this deduction been requested If yes,state amount of deduction
other count' ,,.,.��� co paperty for In Indiana? es LtFNo (ri l.s(fl current year? ❑Yes 0 N
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 at
•
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 aforementioned property on date application is filed.
Sb ( rs name) Date(month,day,yew)
Y aim h/PILAA,r) -i d t Wo2-o/g Fuli address of applicant(number and street city,state,and ZIP code)
402 6. MviIl.erry Strict- Fort &(and.), 1 NV 416(48
Person authorized by duty extftd Power of Attorney or by Ice-1.1.1m.7
Date(month,day,yea'
Address of authorized person (number and street city state,and ZIP code)
,L The penalties for perjury can include Imprisonment up to two and a half years and a fine not to exceed$10,000.