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Home My WebLink AboutMortgage_Morgan (10) <E'7,'a• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownship g Year FOR DEDUCTION FROM ASSESSED VALUATION ` �. State Form 43709(R13/10-15) GIBSON \ `�0 0 20t0 ��---�� Prescribed by Department of Local Government Finance - a� :me File Mark INSTRUCTIONS: 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. i� Must be filed or postmarked.with the County Auditor or County Recorder of the county where the pro.. "►is• • County Auditor located on or before January 5'of the immediately succeeding calendar year. Ii_ ,o \ Recorder 2) Mobile/Manufactured Homes not assessed as Real Property:Must:file with the County Auditor•ofthe county -. where the property is located during the twelve(12)months before March 31 of each year the deduction is night. , I , See reverse side for additional instructions and qualifications. lV Applic ( neror contract buyer- a strictions on erne side).. 11 ? v—e) 0?0, • °Ir_.,..ci. Toxin• �' 'ct Key nu /I gal description tS'o�'<=r: mber Page er A- ed value of real property as of Mortgage/ContracOndebtedness unpaid as of Mortgage/Contract indebtedness unpaid ehfl k the applicant the sole /essment date,current year assessment date,current-year date of a pl' 4aVor equitable owner? /6/161,00LiOL Yes ❑ 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 t property in question:Annually Assessed Real Property ❑ AnnuallyAssessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller a • • Address of mortgagee or contract seller(number and scree ty,state,an code) Name o f assignee or o - • r. r holder o ga e - . 2., ,,, 4,, , ,/ ,, , ,,,,z), Address of assignee(numbelfa treet,city,ty sta ,and ZIP code) , 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 yeah ❑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 Signature of County Auditor County Date(month,day,year) 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. Signature(owner's full name) Date(month,day,year) Full resident address of applicant(number and street,city,state,and ZIP code) 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. CEIPT FOR FILING STATEMENT OF MORTGAG OR C TRACT INDEB Na '• applicant • Na a mortg eeorc. - s er 4f-, , Lp i �# zi/A, I=t: ed(month,day,year) Amount dness dle21pis ��O1.6:3.0!. .i.u.zii:irift:6.DITOR OPP, N,v Ke mber/legal description Q 1 202O fer Signature" of u Auditor 4CountyReco:•� County, � GIBSON .4 .N. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year 7A`',..-; FOR DEDUCTION FROM ASSESSED VALUATION Itr t i State Form 43709(R13110-15) GiBSON �° ,®,a f Prescribed by Department of Local Government Finance INSTRUCTIONS: File Mark To be filed in person or by mail. Form fled with: Filing Dates: 1) Real Property.Must be completed and dated in the calendar year for which the deduction is sought.�.`r Must be filed or postmarked with the County Auditor or County Recorder of the county where the pro is/f County Auditor located on or before January 5 of the immediately succeeding calendar year. �y 2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county r,.y- Recorder where the property is located during the twelve(12)months before March 31 of each year the deduction ispopAght. See reverse side for additional instructions and qualifications. t Uli Applica9pf(eWneror contract buyer-fe0)strictions owearse side). 4 2n • Taxin ct, � Key nupt f I gal description }, I -. r mber r r .�Q� y, Page number f, r 1, vn r a' .f<.^,.,: as '. s , ,- r i "Vi7) 1. .,3<, J ;.), Emir:s' _ 1-- :) =r`t' .,' ,/ 4:✓' w::r �; f OU, ' .37 t1 6 �Asied value of real property as of Mortgage r Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as-oa 14 the applicant the sole essment date,current year assessment date,current year date of appf tion jpl6r equitable owner? 1 /'' �'� vL' 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 property in question:Annually Assessed y Real Property El Annually Assessed Name of mortgagee or contract seller,`. . a , Mobile Home(IC 6-1.1-7) Address of mortgagee or contract seller(number and street/gry,,state,a�code)." r4 I Name of assignee or 011j t holder, io gaffe / I /� ; �``fI5 r 'sC' . ® f �� ale? -'1 ? . }f� ) r �w%If— Address of assignee(number aob/treet,crr) stale and ZIP code) ." ir' L` 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 0 No current year? ❑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 Signature of County Auditor County Date(month,day,year) I 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. S'�nnature(owner's full name) Date(month,day,year] Full elide d rest lira t umber ands cr stet and P code , d,-- .t- (-: e lc- - ,. •. -I. -1-41/1)— 3 Y Person authorized by duly executed Power of Attorney or by I 6-1.1-12- .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. F�ECEIPT FOR FILING STATEMENT OF MORTGAG OR CQ'NTRACT INDEB Nanye applicant •- f a . Nar�re mortg ee or cc�lit sr F "7�d�' . . r �J'i f''�.G'Ff� :y n�' - f yI,��yj�'�``r/"�-'' 4,1 i�,�,+.:+'� � •' .S.r° E�� , Q�t�ed(month,day,year) i Amount di dnessTayin7bistyet )pf� /� �] j� /,:' �`' \` /;r y. ,r°ia,tl;,�(` e` +-,.f. 77j "-'''' UN 1 1 �ttzU Kely.yjomber f legal description // �t • Signature of 9t6uryty Auditor/,County Reco County - 1 _. i r ,1,, _ ---'7,,,,,. .."6 . I /-lice-mi 1:1I0on , _ -