HomeMy WebLinkAboutMortgage_Hirsch (10) ,t..-v�Ii:. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township . Year
, .. `•1 FOR DEDUCTION FROM ASSESSED VALUATION Gibson 0 2020
s' State Form 43709(R13/10-151 RECEIVE®
%' pr Prescribed by Department of Local Government Finance-ferf APR 1 q
3 2020
INSTRUCTIONS: �`..1�{ File Mark
To be filed in person or by mail. L 1, 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 0 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)
Michael Wayne Hirsch
Taxi �D}'strict2 Key number/legal description R rd number Pabliumb err
L 1-JI frI 26-19-18-303-000.224-026/EASTVIEW 3 �A . C
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
asses men ate,current year assessment date,current year .date of application legal or equitable owner?
/�_L n k' LD°-l � $63,050.00 1,6s 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 p erty in question:Annually Assessed
eal Property 0 Annually Assessed
Mobile Home(IC 6-1:1-7)
Name of ma ee contracteditseller y code) IT Heritage Federal Credit Union ,,,,,..„
Address of mortgagee or contract seller(number and street,city,state,and ZIP
5388 Old State Road 66, Newburgh, IN 47630
Name of assignee or other owner or holder of mortgage APR 17 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? Has, r%,:. ar: -r requested If yes,state amount of deduction
other county GI� N�, DI
in Indiana? Ell Yes o curren yea -
Ngb
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 I 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,y ar)
` g .mi Gibson tA'1-7• ?C7
I/We certify under penalty of perjury that the above an 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(owner's f I name Date(month,day,year)
e)
Full resident address of applicant(number and reef,city,state,and ZIP code)
105 S WILLARD ST FT 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)
-,.- _: n.,,.-r.,.ro dmnricnnmant tin to hen and a half years and a fine not to exceed$10,000_