HomeMy WebLinkAboutMortgage_krohn <4 nak STATEMENT OF
RTGAGE OR
ACT
•° *-= a FOR DEDUCTION FROM OM ASSESSED VALUATION INDEBTEDNESS County ' Township Year
:: 7.'i= RECEIVE)
<<(� �;x State Form 43709(R12/6-14) Gibson Johnson 2021
''''•-js,41,--4, Prescribed by Department of Local Government Finance
JUN 2 6 70'U File Mark
INSTRUCTIONS: al -"
To be filed in person or by mail. Ulf1119i G C•-• 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. ❑ 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)
Brandon Krohn and Brittany Krohn
Taxing District Key number/legal description Record number Page number
024 26-23-07-200-001.723-024/HIRSCH LAKE EST LOT 5 D-9,Gibson County 10390 0060D5.
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of application legal or equitable owner?
/1 q 5 ❑ 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 the property in question:Annually Assessed - • -
❑✓ Real Property ❑ Annually Assessed
- �1 t
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Bank of England
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
PO Box 3490, Little Rock, AR 72203 JUN 26 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
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? ❑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 fine 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 . I 20 20 20 20 20 20
Signature of County A + • Coun Date month,da,year)
6 *1 . 3
SQL .2 . 2020.
I,We certify under the penalty of perjury tha the above and foregoing information's rue 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 ner's-full-name) - ---- -- - - - Date(month,day,year) _—_
/� ` -- g —(- . • 20
Full resident address of applicant(number and street,city,state,and ZIP code)
208 East Hirsch Woods Lane, 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 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. plicant ---of .•rtgage=•r ctse r
ra OGiei.4--tn a krbr` - , f V i
Date f d(month,day ear) 9 Am unt of del ? e f. �r T g Dist ict
�• 26. E . 1�`; :r� ._. Jp h� •c Key number/Ipal description 2020 2 — 2 J^ 2
. 7 0�- 2 —00l .—725- c02C0�1N 26
Signature Co Audit r/Coun eco r County Date( onth,da year)
GIBSON COUNTY AUDITOR