HomeMy WebLinkAboutMortgage_Muncy (2) . "'n s STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS• County I Township I Year
FOR DEDUCTION FROM ASSESSED VALUATION Gibson 2019
State Form 43709(R13/10-15)
�i�5/ Prescribed by Department of Local Government Finance
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. A 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)
Chase Oliver^li Muncy , Meghann Ashlee Muncy
Taxing Districtp- Key number/legal description Record udff Pa e�m r
Jvt purr 26-19-35 400-000.629-024
�
Assessed value of real propertyas of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness un aid as of Is applicant the sole
nc pcsment date,current year assessment date,current year date of application I I or equitable owner?
$800.00 - 29,500.00- Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Isjile property in question:Annually Assessed
us al Pro 0 Annually Assessed
me(IC 6-1.1-7)
Name of mortgagee or contract seller
Heritage Federal Credit Union /
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
5388 Old State Rd 66 P.O. Box 189, Newburgh, IN 47629-0189 JUN .0'6 2019
Name of assignee or other owner or holder of mortgage ////�����
ilfkEt
Address of assignee and street,city,state,and ZIP code) GIB$ON COUNTY �I OR
Does applicant own property r ny If yes,what county? What Taxing District? Has this deduction been requested If 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 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
AWisi,esta
Sign tyre of Coun K si; County Date g fp,ti
year)
(�lJ m� bs (C) (/finl4ti/We certify under the penalty o perjury that theoregoing information is tr nd correct and that the applicant i ident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sig a /(owner's hillDate(4olt9 day,yeyear)Full resident address of applicant(numb and sire ,a , t 44,1(ell.LLate,and ZIP code)
Hwy 68 E Oak Ridge Estates Lot 28, Haubstadt, IN, 47639
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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S 10,000.