HomeMy WebLinkAboutMortgage_Morrison (2) " • STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township ' Year
FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R14/1-20) Gibson Johnson 2020
Prescribed by Department of Local Government Finance
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. 0 County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is
located on or before January 5 of the calendar year in which the property taxes are first due and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jared R./Allison D. Morrison
Record number Page number
Johnson 26-22-14-300-000.121-024 2020-2421
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?
$340,000 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
Ij Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
First Federal Savings Bank
Address of mortgagee or contract seller(number and street,city,state.and ZIP code)
111 a
Name of assignee or other owner or holder of mortgage '
Address of assignee(number and street,city,state,and ZIP code) PAI r ® '5:0
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been reques d If ye s 'lrt of deduction
other county on property for 1 a
in Indiana? ❑Yes No® current year? ❑Yes t ICS OR
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contr�yyffi►tde tednes's' tat is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)tha s`the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Sign re of County Audito County+1,/ Date(month,day,year)
• VYuC_ 1 �f�CJsSb7t� F' - 2.0 2f)
e certify undeUe penalty of perju 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.
Signature(owners full name) NliS0(1 D.
Mort Stx- J z-ctr-t (2. fylord-zs Date(month,day.year)
Q4i I C, l I a8(o3 12D�
unit resident address of applicant(nu ter and street,city,state,
2444 W. 1300 S., 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 S10,000.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBT
Name of applicant Name of mortgagee or contract seller r
Jared R./Allison D. Morrison First Federal Savings Ban
Date fled(month,day,year) Amount of indebtedness Taxing District 20rto
$340,000 Johnson p�G 0 3 L
Key number/legal description
26-22-14-300-000.121-024 •
Sign f County Auditor! nyRecorder County Date e ToK
Gibson G-gS U