HomeMy WebLinkAboutMortgage_Menke (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
``ter.__• County Township Year
:,%`' � ; FOR DEDUCTION FROM ASSESSED VALUATION
-1.1• 't State Form 43709(R13/10-15) R EC E W E 0 GIBSON 024 2020
-•`
°',"''1 Prescribed by Department of Local Government Finance
INSTRUCTIONS: Kk(1-tiftedijk('\rr ( SEP 1 8 2019 File Mark
To be filed in person or by mail. Formd with:
Filing Dates: 1) Real Property.Must be completed and dated in the calendar 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 IX1 County Auditor
located on or before January 5 of the immediately succeeding calendar year. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the CountyAudltor 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 restricffons on reverse side) Michael/Marla Menke
Taxing 4Distda 'Key number/legal description 26-22-14-300-001.581-024 Record number Page numberQ
Assessed value of real as of Mortgage/Contract indebtedness unpaid as of Mortgage2020 c the
propertyp I Contract indebtedness unpaid as of Is the applican the sole
assessment date,current year assessment date,current year date of application $ ) 0 , O • legal or equitable owner?
y V ] 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: 4 Y ll.the• •perty in question:Annually Assessed
I .- rkt -.1 Property ❑ AnnuallyAssessed Mobile Home(IC 6-1.1-7)
7)
Name of mortgagee or contract seller
e i k.1 • SEP 3 6 2020
Address of mortgagee or contract seller(number and street,city,state,and ZiP code)
Name of assignee or other owner or holder of mortgage
GIBSON- COUNTY AUDITOR
Address of assignee(number and street,dry,state,and ZIP code)
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 El No current year? ❑Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the persons 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 Aud County Date(month,day,year)
YYl --\1() CabC7e ____ G'son q 30, O Zo
I iWe certify under the penalty of perjury that teand 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.
). Signature(own is fu(1 name) Data,) ��
Full resident address of applicant(number and street,city,state,and ZIP code)
12941 S Sunset Dr, Haub,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,dry,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a tine not to exceed$10,000.
_ _ RECEIPT FOR FLUNG STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS .
Nam of�appiica f ti Name of mo or contract seller
M. aq/ '=rla Menke 11..a...rx-_-1-`1,,, ..-
Date red(month,day,year) Amount of indebtedness 1_] Taxing District 024 Fri
Tlegalde ptdon j
Key numb r
26-22-14-300-001.581-024 240 _11 k-) m
l�.e b
Signatu f - ty Recorder �^ C--- County Date(non coy,}Gar)
Gt_C�SON COUNTY AUDITOR
1 J'l GIBSON CA• �Y/1 `� d+d