HomeMy WebLinkAboutMortgage_Boyer (2) `f;; F, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
x ,!, . State Form 43709(R13110-15) GIBSON 025 2020
1
.,6 1Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
TdRbe:fried6r.-petsett or/4 0RalT. FaIntfited with:
•FrTrngOates•1)4 ReaPProperty:Mbsttfe•complhted'errecbterficribs•cafer faryearkyswhiclilhenredbctidmil-swag/it' .
Must be filed or postmarked with the County Auditor or County Recorder of the county where the properly is X] 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 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 foradditional instructions and qualifications.
Applicant(owner or contract buyer-see restricffons on reverse side
Keith A Boyer
•-Taxies District -Xey,numberllegal description -Record.nremhaT •Page.aumber .
025 26-18.-13-200-1)02. 66-.025 - 3657
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract Indebtedness paiid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$153,7-: Yes 0 No
If no,what is his!her exact share of interest? If owned with someone other than spo•se,indicate with .•om
If name an record is different than that of applicant,indicate below: Is the property In question:A•nually Assessed
0 Real Property 0 Ann s.11yAssessed
•X• Pbebile errre.(IC6-1:14)... -•
NamemfrnortgarisporcaMra .seller Loan Depot
FT D. ."---4)
A ` A
Address of mortgagee _a.
or contract seller(number and street,city,state,and ZIP code) ,!�, r1
Name of assignee or other owner or holder of mortgage OCT 0.5 2020
Address of assignee(number and street,city,state,and ZiP code) 4. !/!-- I
'Daes'tapplimntammerDperrICA!rY trato unhatsaunty v. •-• :Tatdrig-District? .Has 1t� ft-�i�irP�- . _ ^
other county onpro a for3iesrr7bSfhH 1f} f urrtdeducttDn .
In Indiana? ❑Yes ❑No current yea ❑Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or ndeb at 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 t 20 - 20 • 20 • 20 •
Signature of County Auditor CountyDate(mon -gear)
g ty ,�C-_,) GIs on ( 'II°
1 i/We certify under the penalty of perjury that the oregoing information is true and correct and that the applicant" re Went of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature o er's full name) / Date(month,day,year)
d'q
.Full resident address of applicant(num•er and hand ZIP code)
• .5 4•Vff R 168,Fort branch,IN 47648
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 perpury can Include imprisonment up to two and a half years and a fine not to exceed$10,000.
. RECEiPPT FOR F(CING STATEMENT OF MORTGAGE OR CONTRACT t.NDEB•TE I_• SS. .
:,.tgame•n£applicaot Keith A Bbyer Plame.o.fmorigagewarrxtntractsaler Loan Depot .
. Date filed(month,5y,yey� ^ ei ^ 'Amount of indebtedness 1 '���E-1- 1 ng District025
/' )• (,� r/`/ , •
Key number/legal description 26-18-13-200-002.266-025 OCT 0 5 2020 ,-0� — 3G )R-- -
Signature of Audito�r ^Coun ecorder County oC Date(month,day,yea n ^
w \ ^ W
• GIBSON NTY AUDITOR