HomeMy WebLinkAboutMortgage_Gries (3) �E�,,a� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
�'' FOR DEDUCTION FROM ASSESSED VALUATION
a"� .,... v. State Form 43709(R14/1-20) GIBSON Johnson 2020
a ,eie=` :" Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail.
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. 1Z1 County Auditor
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 calendar year in which the property taxes are first due and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Kalena M. Gries
Taxing District Key number/legal description Record number Page number
Johnson 26-23-07-300-002.576-024 ' Z020.2727
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 or equitable owner?
$104,000 WIYes ❑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,it - - Is the property in question:Annually Assessed
D,L( .0 — c.2. 7,,- 7 0 Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller t l '?'
Fifth Third Bank Drawer NO S : 0
Address of mortgagee or contract seller(number and yA
Name of assignee or other owner or holder of mortga Card NO. O C T d 6 2020
Address of assignee(number and street,city,state,ano Lit-cone) A _.,,,/
II n�'Jo1gUl_TI I
Does applicant own prope i any If yes,what county? What Taxing District? Has this deduction been rRG Q 1\ Ig414�at6'dm&d'n4 t"r ion
other county on property for ❑ rt„geetG�
in Indiana? El Yes No current year? yes
NoA person is not entitled tothis deduction unless the person has a balance on the person's mortgage or cct 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
Sig e County Auditor �j►� County Date(month,day,year)
f � r GIBSON 10/16/2020
I/ e certify under the penalty of perjury above and foregoing information is true and correct and that the applicant is a resident of Indiana and
/' ner/contract buyer of the aforemention property on date application is filed.
I' _ iture( (ulKahAta iname) Date(month,day,yea
(*(*//yy�U����) ,year)10/16/2020
Full resident address of applicant(number and street,city,state,and ZIP code)
432 W 1200 S, Haubstadt, 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)
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