HomeMy WebLinkAboutMortgage_Parmer (2) n,. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDN� County Township Year
�A FOR DEDUCTION FROM ASSESSED VALUATION44 GIBSON JOHNSON 2018
S� State Form 43709(R11/6-09) J. Y
"mil Prescnbed by Department of Local Government Finance
20`8 File Mark
INSTRUCTIONS: �1 C -
To be bled in person or by mail. .. (\v f+V Form filed with:
Filing Dates: I)-Real Property:Must be completed arid dated in the calendar year for whi '(he deduction i s t. •
_- n Must be filed with the County Auditoror Co Coury Auditor
unty Recorder of the county where the pro a located ❑
. on br before January 5 of the immediately succeeding calendar year. • ,L' 1-(0R --.❑ ' County Recorder
•2) Mobile/Manufactured Homes not assessed as Real Property:Must Me wi ApditcrCof the •. _ .
county where the property is located during the twelve(12)months before rjh",$ti each year the
deduction is sought. - . G05° • -
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
MATTHEW R.PARMER&AMY M. PARMER
Taxing District Key number/legal description R hum r Page number
JOHNSON 26-22-01-102-001.055-024 , number
JOHNSON
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,current year March 1,current year date or application legal or equitable owner?
185,800.00 161,125.00 266,500.00 ❑ Yes 0 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
❑Real Property ❑Mobdeu Annually
(e CeG7.1.7)
Name of mortgagee or contract seller
FIRST NATIONAL BANK OF CARMI
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
201 E.MAIN STREET, CARMI, IL 62821
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 other If yes,what county? What Taxing District? - Has this deduction been requested on property
county in Indiana? - - for current year?
❑ yes ❑ No - ❑ Yes ❑ No
COUNTY AUDITOR • i
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 I contract buyer of the aforementioned property on date application is filed.
Signature(owner's full name) r (.. ..,Tr n,r�nn
X 77a r / ivy i QJ U r�/L, --• ////c/ a
Full resident address of a�� er and street.city,state,and ZIP code) .
//O) cr/c"fr s tr ,,- c9 /L.I-s,.4svaa/s, mil/ '77,13 9
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)