HomeMy WebLinkAboutMortgage_Goddard (2) -0,e , STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
!= FOR DEDUCTION FROM ASSESSED VALUATION Gibson Johnson 2020
MsS� a/� State Form 43709(R14/1-20)
Prescribed by Department of Local Gover nt Finance
JUN 19 2020 File Mark
INSTRUCTIONS: To be filed in person or by mail. Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. Lr I County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property ,
is located on or before January 5 of the calendar year in which the property taxes are first due and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
John R. Goddard and Amy L. Goddard
Taxing District Key number/legal description Record number Page number
26-23-16-200-002.480-024/WARRENTON PLACE SOUTH 220 3 2Q
Haubstadt ri�h 17 C,
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the appr Rt the sole
assessment date,current year assessment date,current year date of application legal o quitable owner?
$308,750.00 Yes ❑ No
If no,what is his/her exact share of interest? • If owned with someone other than spouse,indic• -with whom
If name on record is different than that of applicant,indicate below: Is t - property in question:Annually Assessed
y :.I Property ❑ Annually Assessed
F IL, y _ Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Heritage Federal Credit Union Address of mortgagee or contract seller(number and street,city,state,and ZIP code) JUN 1 9 2020
5388 Old State Road 66, Newburgh, IN 47630
Name of assignee,or other owner or holder f mortgage /tdt--
Address of assignee(number and str t,city,state,and ZIP code) GIBSON COUNTY AUUI I OR
Does applicant own property in a If yes,what county? What Taxing District? Has this deduction been requested r If yes,state amount of deduction
other county El O on property for El Yes El No
in Indiana? current year?
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 Audi ` �J ,� County Date(month,day,year)
Gibson kock. 2,0-20
I 1 We certify under penalty of perjury that the move 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.'`am 2
e) r ;,yam Y ,,j / Date(month,dyfyear)
.-,.t •<
Full re�-address of appli nt(number and street,city,state,an ZIP c e
1660 E.Autumn Ridge, Haubstadt, IN 47639
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 penury can include imprisonment 1113 to two and a half veers and a fine not to exceed S10.000.