HomeMy WebLinkAboutMortgage_Parker (14) 4,F R^,�, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownship ' Year
"%a,..f\a FOR DEDUCTION FROM ASSESSED VALUATION
S1J',`.'th State Form 43709(R14/1-20) Al' Gibson Patoka Township 2020
' `4-4 Prescribed by Department of Local Government Finance r.
role
, File Mark
INSTRUCTIONS: To be filed in persorLor-by mail.
Form filed with:
s
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. VI County Auditor
Must.be filed or postmarked with the County Auditor or County Recorder of the county where the property is
,r r 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)
Darrell G & Mary B Parker
Taxing District Key number/legal description Record number Page number
Patoka Township 26-11-14-101-001.796-027 2020 S f02
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?
$ 127,000 WI 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 contract selle
Elberfeld State Bank
Address of mortgagee or contract se Drawer NO �u•�
Name of assignee or other owner or 3Z-...4SEP 2U2o
Card NO. ..
'Address of assignee(number and sb i;l
1
C�+NI n COUNTY AUDITOR
tdt k Does applicant own property in any If yes,what county? What Taxing District? Has 4Ni peen requested If yes,state amount of deduction
otin er Indiana?
county Yes No Gibson Johnson on prorent year?
for Yes No
in Indiana? ❑ ® current year? ® ❑
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 2 20 20 20 20 20
I c_.3Ci
Signature of County Audit r County Date(moot day,year)
Gibson f , / w
I/We certify and r t 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 dale application is filed.
Signature4r(ow er^; trfk0)WiSiaj` S,X^ *41 r 4 y.
e onfh da ea x I
Full resident addres-of-applicant(numbe .-street,eity state,and ZIP code) ---a--------_
1806 W. Burlington Place, Princeton, IN 47670
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)