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HomeMy WebLinkAboutMortgage_Miller (22) C_-r-'y GiNgt;LW1 x/�� V'�� W` S ' i11.C-4V _.. .._.�- —}r_` Township Year 1< •... STATEMENT OF MORTGAGE OR CONTRAINDEBTEDNES County �� �d 2� `, FOR DEDUCTION FROM ASSESSED VALUATION GIBSON I a�..:.. •I!" Stale corm 437i19(R13 f itT-t`) a; .'•� Prescribed by Department of Local GovernMent rinancr File Mark Form filed with: INSTRUCTIONS: To be fled in person or by marl. County Auditor Filing©ales. 11 MReal PmPerlr Must be ust b filed orpostmarhed/lpred with therd doted in the C%ountyAuditor or Corrnfy leecortlPrrof the n�niy wttere the property is located on or before.ranuary 5 of the Immediately succeeding calendar year. County Recorder 2) Mabi:ifi ;irganutech rf Noises not assessed as Real Property.Must fire 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 to add?ional rnstrucGons and qualifications. - Aep6ca vner or ecr er sea restryons on rev`e{de) L"\tkl -T . .\I - 11` Reeor ba Pale number ii-a. p,s,.•>� -� Key,number J legal desertnryt-i�on �� /�a/..�� �--�/•3 • po 1—t— g Acsrc=cd a ue a p3;^-e iy a of Mortgage)Contact indebtedness unpaid as of Mortgage!Contract andebtedn�unpaid as of legal r elli able owner? cases ,er.;Cate,rs rent year assessment date,current year p d of aypl tior�11�, -r legal r ell nt the sole Yes 0 No 1't^a tNhat nrs I her exact share.of interest? if owned wsomeone other than spouse.indicate with whom ! f property in question:Annually Assessed i`name on record is different than that of applicant,indicate below: El Annually Assessed Mobile Home(IC 6-1.1-7) 'Nzme of mortgagee or crtract seller �((,���. greAcc�nI c i't"-'\r F -, r Adnrsss of mortgagee or contact seller(numbe d street,city.state,and ZIP code) y� wsd '"lame at assignee or other owner or holder of mortgage !JUR 2 ) Acdress of assignee(number and street,city,state,and ZIP code) 202 i ':Ides applicant own property in any If yes,what county? (What Taxing Distric Has this d rd�eeyd 1 I' if yes,state amo i of deduction ,i-.nc county LiYes ❑No I ctnum tJ N T ndana? tTOR A person is not entitled to this deduction unless the person has a balance on the rson's mortgage or contract indebted ss that i recorded in the county recorder's office(including any home equity line of credit that is recorded in the co recorder's o ice)that is the is for th eduction., COUNTY AUDIT Deduction approved in the amount of: 20 On 20 20 20 20 20 #S=c-at.ne of ty trot County Dat Month da ,year) 1 / 22 23 1 I I we certly under e penalty of perjury tha le above and foregoing information is true and correct and that the applican,is a r ident of Indiana and I r.„Dly i,. tract b er of the aforemention roperty on ate application is filed. t tatare,to met it name Date t d year) t y'_ en edress of- rr. r lumber d street,,.$state,and Z1P l Person aulnorrized by d Iy eyeculed Power of Attorney ar by C 6-1.1-12-0.7 ' a e{} ,Year) Address of authorized person (number and street,city,stale,and ZIP code) MA 2 3 2020 \ The penalties tor pet jurycan include Imprisonment up to two and a half years and a fine not t exceed$10,000. 11 _ __ RSE3AF G011N7yi,RECEIPT FOR FILING STATE--OF OR Na a appi\� � MORTGAGE OR C TRACTlND�$T S \tom t t T 1 (eAmbof mortgagee of .Da ed nth,day,year) 1h �` �►f�:Nt\ \S k...- r Arnoun fine Bs t✓0 ''�tiO Trstrlct Q K�numberl legal description�� u Signature of Cou 9 ,I. i Coun- R•cord• i { A A ad L County Date txttfi,de ye: 4110 GIBSON --- .,��4 % 0