HomeMy WebLinkAboutMortgage_Hedge (2) -'7k• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
1 • 't FOR DEDUCTION FROM ASSESSED VALUATION
° .�_ If State Form 43709(R13/10-15) Gibson ? n 2019
0.-,r.,s 1:--e" Prescribed by Department of Local Government Finance
INSTRUCTIONS: 10-0111ACtikk, • File Mark
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 Q County Auditor
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 ❑ County Recorder
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)
Timothy W. Hedge and Kerijean Hedge
Taxing District Key number/legal description Record number Page number
Princeton 26-12-07-201-000.683-028/ OLD_ PLAN 102 PT 2 u
0 1 vy ,5L �j` O
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 application legal or equitable owner?
$0.00 $73,791.19 A 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: s he. i.-, -stion:Annually Assessed
i'll R4. ripe-rt 0 Annually Assessed
, (, - Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Springs Valley Bank&Trust Company 20�9
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) DEC 1 .
1500 Main Street,Jasper, IN 47546
Name of assignee or other owner or holder of mortgage
kr.
Address of assignee(number and street,city,state,and ZIP code)
�IBsoN couNTY ��i�rroR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction l it requested If yes,state amount of deduction
other count' on propertyy 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 recorders 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 ito County Date(month,day,year)
k- 3nn C Gibson
•
I/We certify under penalty of perjury trta a 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.
ature``\+er's fu am•` , ) . • �/� Date(month,day,year)
Full resident add : applicant numb A `K� ��,'J \ � !\ ,&~ '-a pp ( d street,city,state,and ZIP code VVV
214 E.Walnut St.., Princeton, IN 47670
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 S10 000.