HomeMy WebLinkAboutMortgage_Allen �' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
'jai;' FOR DEDUCTION FROM ASSESSED VALUATION mbso�tC � nson ?�l�
S• State Form 43709(R13/10-15) 1 9 .�Pl
' 5 Prescribed by Department of Local Government Finance 5—14-14
File Mark
INSTRUCTIONS: Form filed with:
To be filed in person or by mail.
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought. 0 County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the 0 County Recorder
property is located on or before January 5 of the immediately succeeding calendar year.
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 side)
John G. Allen and Billie D. Allen
Taxing District Key number/legal description Rn�ard qugber Pag4 pym/ber
11V1,5br1 .26-23-12-402-001.120-024 c,LU/ 7 / d
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 Ire equitable owner?
9. 1 1000 282,487.00 Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
It name on record is different than that of applicant,indicate below: Is prope in question:Annually Assessed
FIL I . ••=•: ❑AnnuaOy Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller I.
Mortgage Research Center, LLC •
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) mg 3 2019
1400 Veterans United Dr, Columbia, MO 65203
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street.city,state,and ZIP code) GIBSON C AUUrreR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested It yes,state amount of deduction
other county _/ on property for
in Indiana? ❑Yes No current year? ❑Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the persons 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 amou -
N
20 •04) 20 20 20 20 20
Signature of u . • •itor a /y ��) Coun '\ Date(month,day,yeyy�
/ J(y �[�LCJ00 S °I
II We unser the •enalty of perjury that the a uvc n.J fuiegoing information' t ue 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(o • eYs lull )i,, „ /� a ����]�� Date(month,day,year)
�ii/�i (6.zi,/C/--� LyC//e"— 04130/19
F ' esi•'nt address of applicant(number and street,city,state,and ZIP code)
53 1 E 1150 S, Haubstadt, IN, 47639
P. •n 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$10,000.