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rt•�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
.i ; FOR DEDUCTION FROM ASSESSED VALUATION
tState Form 43709(R13/10-15) Gibson FT Branch 2019
Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be fled 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 property is LI County Auditor
located on or before January 5 of the immediately succeeding 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 side)
C & T Development LLC
Taxing District Key number/legal description Record nnem r Page uuber
4 Parcels as Colateral (scca c hed 2 I'll 2_ga
value of real property as of Mortgage/Contract indebtedness unpaid as of ' Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment te,current year assessment date,current year date of application legal or equitable owner?
152,500 ❑p 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 the property in question:Annually Assessed
❑� Real Property ❑ Annually Assessed
V
Mobile Home(IC 6-1.1-7)
Name or mortgagee contract seller
Heritage Federal Cr Union Address of mortgagee or contract seller(number and street,city.state,and ZIP code) V\18°)
Name of assignee or other owner or holder of mortgage di:Q`(
If
Address of assignee(number and street,city,state,and ZIP code) N�� /1 0R
rx p10�j
Does applicant own property in any If yes,what county? What Taxing District? Has this dedu se.ne4ted If yes,state amount of deduction
other county on property for V
in Indiana? �Yes ❑No current y�eAa50 e5 ❑No
lye A person is not entitled to this deduction unless the person has a balance on the person's mod 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)
X11, Gibson 7/25/2019
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 hie name) Date(month,day,year)
7/25/2019
Full resident address of applicant(number and street,city,state,and ZIP code)
600 E Strain St, FT branch, IN 47648
Person authorized by duly executed Power of Attoiney 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 exceed510,,000.
RECEIPT FOR FILING STATEMENT OF MORTGAG e: :NTR/{�T`IJJTEDNESS
Name of applicant Name• •rt, ge-,or•• seller'
C & T Development LLC Herit•kte -. r Union(tot
Date filed(month,day,year) Amount of indebtedness 9 9 TfxaVh tistrict
7/25/2019 5152,500 JV\-- !' Ft Branc
Key number/legal description R
4 Parcels (�l • NUO\TO
Signature of County Auditor/County RecorderCounty tG •
OVI��`(
Date(month,day,year)
y, Ca Gibson,Rg0t
(Siyrec‘ b j W Man cile )
•
RECORDATION REQUESTED BY:
Heritage Federal Credit Union
PO Box 189
Newburgh, IN 47629
WHEN RECORDED MAIL TO:
Heritage Federal Credit Union
PO Box 189
Newburgh, IN 47629
SEND TAX NOTICES TO:
Heritage Federal Credit Union
PO Box 189
Newburgh, IN 47629
MORTGAGE
THIS MORTGAGE dated July 24, 2019, is made and executed between C & T Development, LLC, whose
address is 600 E Strain Street, Fort Branch, IN 47648 (referred to below as "Grantor") and Heritage Federal
Credit Union, whose address is PO Box 189, Newburgh, IN 47629 (street or rural route address: 42 Union
Street, (Lenders Address), Sidney, NY 13838) (referred to below as "Lender").
GRANT OF MORTGAGE. For valuable consideration, Grantor mortgages, warrants, and conveys to Lender all
of Grantor's right, title, and interest in and to the following described real property, together with all existing or
subsequently erected or affixed buildings, improvements and fixtures; ail easements, rights of way, and
appurtenances; all water, water rights, watercourses and ditch rights (including stock in utilities with ditch or
irrigation rights); and all other rights, royalties, and profits relating to the real property, including without
limitation all minerals, oil, gas, geothermal and similar matters, (the "Real Property") located in Gibson County,
State of Indiana:
See Attached Schedule C for the full legal description ( , ) (�
The Real Property or its address is c monly known as 103 W. John t,r IN 47643 ,2$ l04 .
Strain Street, Ft branch, IN 47648, 203 W. Strain eet, Ft Branch, IN 47648 103 ark Street, Ft.
Branch, IN 47648.1 �
CROSS-COLLATERALIZATION. In addition to the Note, this Mortgage secures all obligations, debts and
liabilities, plus interest thereon, of Grantor to Lender, or any one or more of them, as well as all claims by
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