HomeMy WebLinkAboutMortgage_Farrington (2) ,ME f**•a,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
='1 FOR DEDUCTION FROM ASSESSED VALUATION tSO(�
i•.. tY = State Form 43709(R13/10-15) q 0 4 2020
'; a Prescribed by Department of Local Government Finance U File Mark
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INSTRUCTIONS: �p kA gy q•2c` �'+O
To be filled in person or by mail (,may tV i Fo sled with:
Filing Dates: 1)Real Property:Must be completed and dated in the cal dar year for which the deduction is sought.
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 immediately succeeding calendar year. County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor of the 0 County Recorder
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Tina Farrington and John C. Farrington
Taxing District Key number/legal description 26-23-16-200-002.675-024/12634 S Record number Page number
Pleasant Valley Ct. Haubstadt, Indiana 47639 260)0 33 q
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 r equitable owner?
$288,500.00 . Yes 0 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 t•- property in question: Annually Assessed
girt. Real Property ❑Annually Assessed
1.,
►� Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract sellers
Old National Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
PO Box 918, Evansville, IN 47706 SEP 2 2020
Name of assignee or other owner or holder of mortgage /
(number and street,city,state,and ZIP code)
y GIBSON COUNTY AUDITOR
Address of assignee
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of
other county on property for deduction
in Indiana? 0 Yes 0 No current year? 0 Yes 0 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 i, 20 20 20 20 20 20
Signature of County A4 County 1 Date(month day,ye r)
♦rl I if C513 sad Ct2 rl—
I/We certify under -natty of perj • - the above and foreg it information is true and correct and that the a plican is a resident of Indiana and
owner/co tract buyer of e aforementioned property on date application is filed.
C y
Sig lure,(b ner's full name D ( o th,day,year)
,,-„),
Full resident address of applicant(numb r nd street,city,state,and ZIP code
12634 S Pleasant Valley Ct., Ha adt, 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)