HomeMy WebLinkAboutMortgage_Kramer (4) 4,ran•-. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
, . , FOR DEDUCTION FROM ASSESSED VALUATION �q�
t1 ["` State Form 43709(R14/1-20) g100 41 . O 2�$ 20�"
'�.f"9 Prescribed by Department of Local Government Finance «IJJJ
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. County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is County Recorder
located on or before January 5 of the calendar year in which the property taxes are first due and payable.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Kramer, Kasey W
Taxing District Key number/legal description Record number Pag \rz
,J.1444eR 0 2 r 26-19-07-300-000.539-025 c c
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the soY assessment date,current year assessment date,current year date of application legal or equitable owner?
IlYes ❑No
If no,what is his/her exact share of interest? If owned with someone othe han spouse,indicate with whom
t.
If name on record is different than that of applicant,indicate below: , 11 Is the property in question:Annually Assessed
' ®Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller - 0Farm Credit Mid-America, FLCA .0- ?
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
12501 Lakefront Place, Louisville, KY 40299 R,�o
Name of assignee or other owner or holder of mortgage U��.,( Q�v
Address of assignee(number and street,city,state,and ZIP code) C�1dsO�CO
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 Gibson Union current year? ❑Yes IZ1 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 County Auditor 1 County Date(month,day,year)
i�(y�e certify under t e enalty of perjury fhe above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementior property on date application is filed.
Si na e(owner's full n me) Date(month,day,year)
07/20/2020
F II resid t address of appli nt(number and street,city,state,and ZIP code)
6079 US Highway 41, Fort Branch, IN 47648
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.