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HomeMy WebLinkAboutMortgage_Blough-Retana Q,�oFAk STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year ° r1'� FOR DEDUCTION FROM ASSESSED VALUATION .,: .a l 3s�'1'.� ;t,f> State Form 43709(R14/1-20) . `�-�_- : a ion (�� �?-o y`,-• Prescribed by Department of Local Government Finance J Farm File Mark INSTRUCTIONS: To be filed in person or by mail. 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. App' nnt(ow er or contract rer-s§e �tri ions o>reversde 1 7. Taxing istrict 1 lo'\ `�f, Key numb legal description Record number Page number © 26 -) �1 ,-1�k- ©off .54�( 0 0 i° �° 3S ct Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the a licant the sole assessment date,current year assessment date,current year date of application legal or ble owner? ``, I . )6 es ❑No If no,what is his/her exact share of interest? If owned with someone otl r than spouse,indicate with whom If name on record is different than that of applicant,indicate below: s e property in question:Annually Assessed F ILE �\ Real Property ❑Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee o�[[contract sellers ,: �'vt(_CiAM ?/4 1 • e ,Cam... . Address of mortgagee or contract seller(numb n an: •treet city,state,and ZIP code) SEP 1.6 2020 Name of assignee or other owner or holder of mortgage %)� q. Address of assignee(number and street,city,state,and ZIP code) 7w�� CdGL GIBSON COU�lTY AUDITOR 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 current year? ❑Yes ❑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 Signature of CountyAud' r G:M...) County Di( cnth,I/We certify under th penalty of perjury that the above and foregoing information is true and correct and that the applica t is a rts,C sident of Indiana and `� o ner/ o ract buyer of the aforementioned property on date application is filed. 4y S' lure( er' full nam Date(month,day,year) Full reside�taddress of a plicant(number a street,city,state,and ZIP code) 04_, . 0Person authorized by duly executed Powe o ttorney or by IC 6-1.1-17Z0.7 Date(month,day,year) Address of authorized person (number and street,city,state,and ZIP code) — Thn nnnnIfien fete nnr6,nr rnn i..rL.rin imnricnmmnnf;In fn hero onrl m hn/f vAmre nnrl n finA not in ovroArl A1n nnn