HomeMy WebLinkAboutMortgage_Garner (2) . 'k4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
— �= FOR DEDUCTION FROM ASSESSED VALUATION
" i'`; . i, State Form 43709(R14/1-20) Gibson jb$Itnek2020
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+ .�- 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. E 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.
Applican wner or coutract buyer-see rest'di ns on reverse side)
Vitt C
Taxi • t' t ey number/legal description Record number Page number
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if- zh/-,Zoz-Ca , 893- Dab MP91)
Assessedvalue of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applica the sole
assessment date,current year assessment date,current year data of application legal a ble owner?
492-1 4 93 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: the.roperty in question:Annually Assessed
N.--al Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Nam ortgagee or contract seller
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Address of mortg e or tract seller / 9
Name of assignee or other owner or ho /"i2 N c V� O CT 1 2020
Address of assignee(number and strei
V ° G '.prOP
Does applicant own property in any ;this deduction be quc5td c TWeV,Ist`tate arri•-nf of deduction
otin nr county )ro❑Yes ❑No ent yrtyea f?or ❑, s� ❑No
in Indiana? �ent year.
A person is not entitled to this dedi Drtgage or contract indebtedness that is recorded in the county
recorder's office(including any hor..__.,_._, . _. _.__.__..__._.___.____.. _.._ _.. _ der's office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
not a of County Audito County Date(mont ,day,year)
/D�i 9/2OI/We certifyunderc47
al of er' at the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
penalty P 1 9 9 PP
owner/contract buyer of the aforemen ned property on date application is filed.
Signat er's II n e Date(month,da,year),
/Zo2t
F re nt address ; nt(numbe and street,city,sta. and code)
/Clip Z L.9-• - ILe--it_ 1 ,--i T-47/414 Et
Person authorized my executed Power of Attorney or by IC 6-1.1- 2-0.7 Date(month,day,year)
Address of authorized person (number and street,city,state,and ZIP code)