HomeMy WebLinkAboutMortgage_Hawes � E ��, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
! t k, FOR DEDUCTION FROM ASSESSED VALUATION
1 tC`' State Form 43709(R14/1-20) Gibson Princeton 2020
• T,N, Prescribed by Department of Local Govei __
File Mark
INSTRUCTIONS: To be filed in person or by mail. • Form filed with:
Filing Date: Form must be completed and dated in t'
iz
Must be filed or postmarked with the( Drawer N to••' ... yroperty is County Auditor
located on or before January 5 of the •'' •• sayable. ❑ County Recorder
See reverse side for additional instructions and qualifk Card NO. ..N2(06
Applicant(owner or contract buyer-see restrictions on reveres ...-_,
Kenneth & Bonnie Hawes
Taxing District Key number/legal description Record number Page number
Princeton 26-12-07-304-000.194-028 - 2020 3QQlQ. ,
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 QC legal or equitable owner?
LAC 00O• zYes ❑No
If no,what is his/her exact share of interest? If owned with someone otter than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the prope in question:Annually Assessed
®Real Pjrp= ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller ;
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) t5('<;, 'ec,to
Name of assignee or other owner or holder of mortgage 0OF
SOjLC' O4
Address of assignee(number and street,city,state,and ZIP code) QG
VA
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested 'I1ps,state ount of deduction ,
other county on property for Q
in Indiana? III yes ®No current year? ®Yes ❑No /T�
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 fine 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
Sign ure of County Auditor County Date(month,day,year)
jer.„6.... rn.. ..A, '.) Gibson 9/18/2020
I/We certify under the penalty of perjury that t abo nd 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.
Signat a(owner's full name) Date(month,day,year)
C.-4lar t�.,� 9//8/20?d
u resident address of applicant(number and street,city,state,and ZIP code)
612 S Main St., 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)
The nenaltlee fnr nerinni ran inrlurle imnricnnment un to twn and a half years and a fine not in exceed$10-000-