HomeMy WebLinkAboutMortgage_Scales (3) �E r*•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownship
�- .'��`'"o Year
7 FOR DEDUCTION FROM ASSESSED VALUATION
31
'I�, State Form 43709(R13/10-15)
4�
ye4 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 ❑ 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)
SCALES, MELANIE R.
Taxing District Key number/legal description Re.rr��o',r``d number Page number
PRINCETON 26-12-18-103-003.453-028 / McKaw Sum 38 Pt/39/40 0.(J' /07i¢
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 equitab e owner?
161,100 —94,250-- '1$ 5U0—' 14-8,9Q0 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 perty in question:Annually Assessed
eal Property ❑ Annually Assessed
--i i Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
First National Bank of Carmi
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
201 E Main St, PO Box 70, Carmi, IL, 62821 MAR 16 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
GIBSON COUNTY AUDIOu
Does applicant own property in If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other coup PRINCETONon proert in Indiana? El Yes No currrentyear?or ❑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.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Si ur of County Auditor County Date(month,day,year)
\SAILt—' . ► hhS(9 3- /L,-Zo 2-[7
/We certify under the penalty of perjury t 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 ner's full name) / — O Date(month,days year)
/ .2 1 /7 v.G2 .3 S oe O
Full res" ent address of applicant(number and street,city,state,and ZIP code)
1116 CAROL AVE, 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 oeriury can include imnrisnnment tin to two and a half vaarc anrd a flop not to avraarl Q9n nnn