HomeMy WebLinkAboutMortgage_Folsom (6) .<,'--`_ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS' County Township Year
jt FOR DEDUCTION FROM ASSESSED VALUATION7Gibson Montgomery 2020
ZI.,. aState Farm 43709(R13/10-15)
kJ Prescribed by Department of Local Government Finance RECEIVED
safes
(� -- File Mark
INSTRUCTIONS: qC� SEP 2 0 2020 Form filed with:
To be filed in person or by mail.
Filing Dates:1)Real Property:Must be competed and dated in the calendar year for which the deduction is sought. County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the '❑ County Recorder
property is located on or before January 5 of the immediately succeeding calendar year.
2)Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the
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)
William A. Folsom , Linda L. Folsom
Taxing District Key number/legal description Reeord n m C.er Pageytn nber
Montgomery 26-17-01-404-000.526-022 �L O 2,�3O
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sale
assessment date,current year assessment date,current year date of application leg or equitable owner?
$91,000_00 63,750.00 ' 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 t property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller F17, Ir
Bank of England
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
P.O. Box 3490, Little Rock, AR 72203 SEP 2 8 2020
Name of assignee or other owner or holder of mortgage
ltYtt'eAddress of assignee(number and street,city,state,and ZIP code) 1� O U NT
• GIBSON COUNTY AUDITOR
Does applicant own property in a 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 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, 20 20 20 20 20 20
Signature of County Auditor 6_,4
County ` n Date month,p day,cy�earr))
/Wm
COQ
•
I/We certify under the penalty of perjury that the above and foregoing information is tkue and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
.Si. -toe w er's full name) Date(month,day,year)
At,( el(, l 09/17/20
Full resident address of applicant(number and street,city,state,and ZIP cod
104 E Poplar St, Owensville, IN, 47665
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 uo to two and a half years and a fine not to exceed$10,000. • 46101