HomeMy WebLinkAboutMortgage_Hightower ,�-74-- STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
� y' FOR DEDUCTION FROM ASSESSED VALUATION
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,�lv•3�.._ > State Form 43709(R13/10-15) � 0
°`" r-i° Prescribed by Department of Local Government Finance
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INSTRUCTIONS: ' File Mark
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 ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. El 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)
Hightower, Kyla M. Phone#. /
Taxing District Key number/legal description Record number Page number
. Oakland City 26-14-18-304-000.880-007 2020 Z2_S'2
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 equitable owner?
117826.00 ❑ Yes 0 No
If no,what is his I 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
0 Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Fifth Third Bank, National Association
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage ''''%-rils.e,
Address of assignee(number and street.city,state,and ZiP code) i7UN
Does applicant own property in an If yes,what county? What Taxing District? Has this deduction been requested J%:yes,state amount of deduction
other county �/ on property for r��_
in Indiana? ❑Yes 0 current year? ❑Yes �'ti:', "jr
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebte.nee i a 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 00t4 U
COUNTY AUDITOR (/DfT0R
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature o o y Auditor ` County Date(month,day,year)
I/We certify under the penalty of perjdry'tfiat the above and 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.
Sign fe/(bwner's full na e)) Dale(month,day,year)
'��s(/�� 'lfLr/',G it{/C7'�Li'1A✓V/‘ 5/29/2020
Full re.ident address/of applicant(number and street,city,state,and ZIP code)
314 S. Walnut, Oakland City, IN 47660
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 oeriury can include imprisonment up to two and a half years and a fine not to exceed Sin onn