HomeMy WebLinkAboutMortgage_Payne (4) •04,4� ._Ta.4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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i .. a��� FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R13/10-15) v�; s Gibson Oakland City 2020
781B Prescribed by Department of Local Government Finance
3,p c d7� 1 � JUL 2 3 Z313 File Mark
INSTRUCTIONS: �-7(� For flied with:
To be filed in person or by mail. ((��
Filing Dates:1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought. County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the County Recorder
property is located on or before January 5 of the immediately succeeding calendar year.
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)
Robert Payne ,
Taxing District Key number/legal description Record number twuner
Oakland City 26-14-18-302-000.679-007 24 20 16 tIO
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is t -applicant the sole
assessment date,current year assessment date,current year date of application .r equitable owner?
$61,700.00 90,808.00 1 '-s 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with w om
If name on record is different than that of applicant,indicate below: Is roperty in question:Annually Assessed
eal Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
F I L First Savings Bank a
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
478 W Meyers Street, Montgomery, IN 47558 .JUL 2 3 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) tar
GIBSON�TY AUDITOR
Does applicant own property in ny 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 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 \111 CC___SP
County Date(month,Ory,year)
DIC-
otlion
I/We certify under the p alty of perjury that the above and foregoing information is trues d 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' full name) Date month,day,year)
i/�(j�J 07/{ /20
Full residentresident of applicant(number and street,city,state,and ZIP code)
310 W Washington St, Oakland City, IN, 47660
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)
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