HomeMy WebLinkAboutMortgage_Houdyshell 0,-mr, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS - County Township Year
7 e,�,; FOR DEDUCTION FROM ASSESSED VALUATION
al `"[J� State Form 43709(R13/10-15) Gibson P Twsp2020
.�----i' Prescribed by Department of Local Government Finance
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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.
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)
Ryan/Natalie Houdyshell
Taxing District Key number/legal description Record number Page number
Patoka Township 26-05-31-400-000.176-027 2020 ] y LQ 9
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?
$142.000 ❑■ 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
'/ _ Mobile Home(IC 6-1.1-7)
Name of mortgagee or contrz DI 0 02,0 .m / / 6, 9 k' f .,
r)
Unify
Address of mortgagee or cor
Drawer NO SUN 3® `2D2O
Name of assignee or other o
Address of assignee(numbs Card NO. GIBSO>0 �
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been Orequested�If yes amount of deduction
•
• other county on property for
in Indiana? ❑Yes No current year?� NJ 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)
Jk i> Gibson 06/30/2020
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.
SXature(ow er's f 11 n e) Date(month,day,year)
Q Q .� 4 ti n��/2 06/30/2020
Full resident address of applicant(n mb r and street,cr state,and ZIP cgde)
I Y 7a N Old ku Poi ! r 72(.e-L TiV7G 7t7
Person authorized by duly executed Power of Attorr et 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)
ThP npnalties_fol oeriurY can include imprisonment up to two and a half years and a fine not to exceed$10,000.