HomeMy WebLinkAboutMortgage_Purcell ,+E74.vy, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
i -. _q , FOR DEDUCTION FROM ASSESSED VALUATION \�,
��� -State Form 43709(R13/10-15) Gibson \1/43.1 2020
--e Prescribed by Department of Local Government
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. ❑ 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)
Alan M/Juli A Purcell
Taxing District Key number/legal description R rd numb Page number
Johnson 26-23-16-200-002.605-024 0) 163
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?
50000.00 ❑■ Yes ❑ No
If no,what is his I her exact share of interest? I If owned with someone other than spouse,indicate with whom
If name on record is different than _ ___-____-_.__ __� -- ---•-- Is the property in question:Annually Assessed
F IL ,I • •-rty ElAnnually Assessed
il
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract se 9011
5/3rd Drawer NO... lJ 1/
Address of mortgagee or contract: .
Name of assignee or other owner c
JUN 1 0 2020
Card NO. tli
Addressfjtns4:c7ga-----
of assignee(number and.
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? Yes No current year? ❑
CI Yes Li 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
Signature of County Auditor County Date(month,day,year)
gg'13 Gibson 06/10/2020
I/We certify under the penalty of perjury that 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.
Signet (owner's full nano))c
Date(month,day,year)
l.il kk0
06/10/2020
Full re d n address of applicant(number and street,city,state,and ZIP code)
162 E Autumn Ridge, Haub, In
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 periury can include imprisonment up to two and a half years and a fine not to exceed$10,000.