HomeMy WebLinkAboutMortgage_Blanton (2) yqp*� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
�'��t.`Y FOR DEDUCTION FROM ASSESSED VALUATION
--' *`li Gibson 0 2020
-'� l State Form 43719(R13/14-15}
�`'ra--;' Prescribed by Department of Local Government Finance r
1
INSTRUCTIONS: ' 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 IZ 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 0 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)
Melissa S. Blanton and Diana L. Koester
Taxing District Key number/legal description Record number Page number
Fort Branch TWNSHP 26-19-18-303-000.767-026/WALTERS ADD 327PT 20 2,01I
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 e `itable owner?
$67,100.00_ __ $159,000.00 _fie-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: Is the operty in question:Annually Assessed
Real 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)
5388 Old State Road 66, Newburgh, IN 47630 1bt
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) FEB j 3 2020
Does applicant rn'm property in a y If yes,what county? What Taxing District? Has this de Son been requ• ted If yes,state amount of deduction
other county on prop .
in Indiana? ❑Yes o ceigg -•',. No
COUNTY
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract inuabteunfina 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 I 20
Signature of Coun ditor � County Date(month,day,year)
All 4"t cis,
Gibson 213-20LO
I/We certify un er penalty of per. ''at the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
-— own /- ntract-buyer-of the of ementioned-property on date application is filed. - •- - — — - - -
�Si is f 1 nary L �� (r� �Ia�{,yea
F I r I n d r ss of ap scant(number and street,city,state,and ZIP code) /// //`/(//f
205 S WALTERS ST., Fort Branch, IN 47648
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$10,000.