HomeMy WebLinkAboutMortgage_Nixon STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear
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FOR DEDUCTION FROM ASSESSED VALUATION
a-.i', / State Form 43709(R13/10-15) GIBSON CENTER 2019
s ` =j° Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed 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 16,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)
Nixon, Charles B/Nora
Taxing District Key numtier/legal description Record number Page number
CENTER 26-12-12-300-000.745-004 201 a 2- - O g
Assessed 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 applicationio legal or equitable owner?
tH 119 // ❑ 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 ❑ A assessed
I _ sIA.) . ob c e(IC 6-1.1-7)
Nam('1 mortgagee orseller L Ad. n � /
ii
Address of mortgagee or contract se number and street,city,state,and ZIP code)
I Name of assignee or other owner or holder of mo Ortgage `�
i
1 '\Z Orc
Address of assignee(number and street,city,state,and ZIP cod( U
Di'a1YeI' ND (7. 13
1--(1) 0\ ' P
Does applicant own property in any If yes,what county? requested Ifiezpite amount of deduction
other county Ndvj
in Indiana? ❑Yes ✓❑No I ❑No G
A person is not entitled to this deduction unless the perso Card NO. •• 9NK - t indebtedness that is recorded in the county
recorder's office(including any home equity line of credit •the basis for the deduction.
COUNTY AUUI r urc -
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 pery'ury 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.
Signature(owner's full name Date(month,day,yeah
10/28/2019
ull resident address of applicant(n er and street, ,state,and ZIP code)
12 5 dy5D 6/ ; , e '/72 70
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)