HomeMy WebLinkAboutMortgage_Busing (2) ege STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County TownshipYear
� io FOR DEDUCTION FROM ASSESSED VALUATION {a '_ ( ) RECE li Eft GIBSON 2020
State Form 43709 R13/10-15 001
.°�� Prescribed by Department of Local Government Finance
INSTRUCTIONS: NI ,,,JUL 3 0 2019 File Mark
To be filed in person or by mail. 70.5_60,
`�� Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for laifich the deduction is sought
Must be tiled or postmarked with the County Auditor or County Recorder of the county where the property is a 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(ownerorcontractbuyer-seerestrictionsonreverseside) Jeffrey/Amy Busing
Taxing District Key number/legal description Record number Page number
Barton 26-20-14-301-001.038-001 7.14R
2020
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?
$145,000 a Yes 0 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 p••: in question:Annually Assessed
❑ Real Property !I Annually Assessed
Name of mortgagee or contract seller 3D obile Home(IC 6-1.1-7)
ir , , a I ,,ETFCU
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
JUL a ®2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
G(�IBSON COUNTY� AUDITOR j
Does applicant own property in any If yes,what county? What Taxing District I Pals this deduction been requested If ,state amount of deduction
other county on property for
in Indiana? ❑Yes CI No current year? ❑Yes
A person is not entitled to this deduction unless the person has a balance on the pers.•'s mortgage or contract inde dness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county re ••.- 's office)th ' e basis for the deduction.
COUNTY AUDITOR .
Deduction approved in the amount of:
20 20_ _ 20 20 20 20 20
Signature of County Auditor County Date0/l24/2 Leer)11i G'son
1.9
I/We certify under the pe Ity of perjury that t e 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.
ir Signature(owner's full name) Date(month,day,year) 1�
.� v* A��� 07/24/2020 't
Full rear nt a d ess of a lica t(number andy
ity,state,and ZIP code)
7144 S 950 E, 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)
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 applicant Name of mortgagee or contract seller
Jeffrey/Amy Busing ETFCU Date filed(month,day,year) Amount of indebtedness Foi T- D istrict001
07/24/2020 $1 �/
Key number/legal description 26-20-14-301-001.038-001 JUL 3 0 2020 Zoic - 7148 •
Signature of o Auditor/County Reco:-r County Date(month,day,year)7/24/2020
mid C3U GIBS f,,, •
GIBSON COUNTY AUDITOR