HomeMy WebLinkAboutMortgage_Lutz (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township . Year
3s . ,b FOR DEDUCTION FROM ASSESSED VALUATION
•'r `t-�' State Form 43709(R13/10-15) Gibson Haubstadt 2020
o\-- es Prescribed by Department of Local Government Finance
tali _
�i CE WED File Mark
INSTRUCTIONS: 'O'-0.A _�j� Form fillwith:
To be filed in person or by mail. MAY 2 1 2020
Filing Dates: 1)Real Property:Must be completed and dated in the calendar)roar for which the deduction is sought. County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the ❑ County Recorder
• property is 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 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)
Emily Lutz,
Taxing District Key number/legal description Reco mb-r_ Page nnuu'per
Haubstadt 26-19-31-301-000.100-009 ,,1�1 V 6
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 I:.- •.r equitable owner?
$106,300.00 116,400.00 •Ares 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 e property in question:Annually Assessed
eal Property 0 Annually Assessed
obile Home(IC 6-1.1-7)
Name of mortgagee or contract seller I Quicken Loans Inc. P
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
1050 Woodward Avenue, Detroit, MI 48226 MAY 2 2 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) •
� V
GIBSON COUNTY AUDITOR
•
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? Ill Yes No current year? ❑Yes ❑No
A person is not entitled to his 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
Signature of County Auditor County 1 Date(m th,rar)_
ml s�rl ,S 220 a
I/We certify under the penalty of perjury that the above an foregoing information is true nd correct and that the applican is a rnt of Indiana and
owner/contract buyer of the aforementioned property on date application'is filed.
Sign e_( ner-s-f Vie) Date(month,day,year)
05/22/20
Full resident ad ress of applicant(number and street,city,state,and ZIP code)
102 N . ' e St, Haubstadt, IN, 47639
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) ® ¢l 4 0
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000. 44658
...0 . a +ifinft