HomeMy WebLinkAboutMortgage_Gerling (2) .0,mtt, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownship
If �, 1\,,, Year
r FOR DEDUCTION FROM ASSESSED VALUATION 1
,v/e State Form 43709(R13/10-15) Gibson 1 1 h.�O 2020
Nq�L: J W
'' '- i, Prescribed by Department of Local Government Finance
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INSTRUCTIONS: t nkl�
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 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)
Aaron R.Gerling and Jenah J.191ttes CCJ-e h l i v�
Taxing tract,. 1 4 Key number/legal des ription Record number Page number
10 i\ • PT SW 24-3-11 2 AC D-4/02(0—I8--021-am>—•o6:>.i s.2— O PS"- 20 20 tS 1-3—
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?
168,333.00 es ❑ 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 p perty in question:Annually Assessed
eal Property ❑ Annually Assessed
• Mobile Home(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) ILP
-(:;
PO Box 129,Naburgh,IN 47629 '''
Name of assignee or other owner or holder of mortgage
JAN 2 7 2020
Address of assignee(number and street.city,state,and ZIP code)
Does applicant own property in an If yes,what county? What Taxing District? t
GIBS 1.i i iqn been requested If yes,state amount of deduction
other county onnpio 1.43,_ j�:•'ftq
in Indiana? Ill Yes o 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.
S
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of CountyAudito{ r County\ Date(month.day,year)
13._
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/contract buyer of the afore/2S `mentioned property on date application is filed.
Signaturur (owner's a V l I Prim �j� asallutin
Date(month,any,year)
���(\/ January 17,2020
All resident address of applicant(number an:LC-"reet,city,state a ZIP code) t
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
January 17,2020
Address of authorized person (number and street,city,state,and ZIP code)