HomeMy WebLinkAboutMortgage_Baehl (3) .�E s'*s STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�, ; ,� County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION ! atAio
";� 1' jA State Form 43709(R13/10-15) RECE9\IED Gibson f1 2020
•, _.=�' Prescribed by Department of Local Government Finance ' 1 •
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--. MAY 1 B 2020 File Mark
INSTRUCTIONS: I � k . ---7
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 X(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)
JASON A.BAEHL and JAMIE L.BAEHL
Taxing District k Key number/legal description Record number Page number
tD
v 26-18-12-300-002.386-025 2 0 2,0 209 0
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,eg gable owner?
238,000.00 rYes ❑ 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 property in question:Annually Assessed
eal Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Heritage Federal Credit Union,ISAOA ATIMA
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) MAY 2 8 2020
PO Box 189,Newburgh,IN 47630
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street.city,state,and ZIP code) GIBSON COUNTY /.U.,'sd t,;)R
Does applicant own property in a 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? Yes o current year? ❑
El 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
1
Signature of County Audit .....4.1 ` County t Date(mo at)
1/We certify under th enalty of perjury thave and foregoing information is tru2 afid correct and that the applicant is residen of Indiana and
owner/contract buyer of the aforem ntioned property on date application is filed.
.Si nature(owner's full name)I/ Date(month,day,year)
\X/\ a U Q � May 14,2020
gill esident address of applicant(num er and street,city,state,and P code)
980 West 650 South,Fort Branch,IN 47648
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month.day,year)
May 14,2020
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.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant T ti�m��-q�f�mjo� �a ee or contract seller �� n
JASON AP BAEHL and JAMIE L.BAEHL +.-, ' 1 g -C� J C"' �10 ' _
Date filed(month,day,year) Amount of indebtedness. I %Taxirig.District
c—ZS -20Z� MAY 20 r.�:,000.00 , U. 1�1
Key number/legal description •- --
26-18-12-300-002.386-025 ,�� . 'C �
Signature of ty ditor I County R orde �(�{ w ;" , , County ,•. �^ Date(month, ay,yyeea— `
YY�I GIBBON COUN t'Y A :D 1""mod bercpt� G �V` - 5 Z-0