HomeMy WebLinkAboutMortgage_Bryant (4) 4.0,ii t,... STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
\s, FOR DEDUCTION FROM ASSESSED VALUATION 2020
i m `_
State Form 43709(R13/10-15)
. .'a' Prescribed by Department of Local Gover7ent Fi nce RECEIVED
File Mark
INSTRUCTIONS:
To be filled in person or by mail. 1 CC- ( MAY 2 2 2020 For lied with:
Filing Dates:1)Real Property:Must be completed and dated in the ndar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor County Recorder of the county where the ❑
property is located on or before January 5 of the immediately succeeding calendar year. County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor of the 0 County Recorder
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)
Jason A. Bryant and Brandy N. Bryant
Taxing District Key number/legal description 26-18-34-400-002.442-024/2707 W 1025 . 'Re numberrd` Page number
U S Fort Branch, Indiana 47648 U O
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applic t the sole
assessment date,current year assessment date,current year date of application legal or itable owner?
$192,000.00 es 0 No
If no,what is his/her exact share of interest? If owned with someone other than spou ,indicate with who
If name on record is different than that of applicant,indicate below: Is th roperty in question: Annually Assessed
Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Heritage Federal Credit Union 4 T-IL,Ea. ,
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) F
5388 Old State Highway 66, Newburgh, IN 47629 cB
Name of assignee or other owner or holder of mortgage MAY `i
2020
Address of assignee(number and street,city,state,and ZIP code) �,A
Does applicant own property in any If yes,what county? What Taxing District? Has^tl 19eii' tT&45 n requested If yes,state amount of
other county GIBS ag dTY AU deduction
No deduction
in Indiana? 0 Yes 0 No current year? 0 Yes
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:
2 20 20 20 20 20 20
Signature o tyAudito _ (.�O County \�� Date(m ay,year) 7 vi'vl
\1v� �j1S *(>
I/We certify under penalty of perjury that the above and fo oing information is true and correct and that the pplicant i a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sig at (owner's fill na Date onth,1dpy year)
ull re nt address of applicant tuber and street,city,state,and ZIP code)
270 1025 S, Fort Bran , 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.