HomeMy WebLinkAboutMortgage_Davidson cn; STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS.tea, County Township Year
w FOR DEDUCTION FROM ASSESSED VALUATION
�I1� state Form a37og R1a/1-20 / 2 Gibson Oakland City 2020
--- Prescribed by Department) pL0 �6 — SJ
Drawer NO File Mark
INSTRUCTIONS: To be filed in person
Form filed with:
Filing Date: Form must be complete( ;ought. County Auditor
Must be filed or postmat Card NO. 7ty where the property is
located on or before Jar, first due and payable. ❑ County Recorder
See reverse side for additional instructiot
Applicant(owner or contract buyer-see restrictions on reverse side)
Travis Davidson
Taxing District Key number/legal description Record number Page number
Oakland City 26-14-18-303-001.229-007 Z 0 1 l°. I--kS�
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?
$83,700 LJYes ❑No
If no,what is his/her exact share of interest? If owned with someone other than spouse,rndi with whom
If name on record is different than that of applicant,indicate below: Is the propert lJl qu ion:AnnuallyAssessed
®Real Propert ❑A nua lyAssessed
Q fu aljte (IC 6-1.1-7)
Name of mortgagee or contract seller tri.
Top Flight Financial or Midland Mortgage �
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) Obb,, Z0��
('O
Name of assignee or other owner or holder of mortgage (/�
TyA
Address of assignee(number and street,city,state,and ZIP code) �00,
O,Q
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 ®No Gibson Oakland City current year? es ❑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
Signatur of County Auditor I County Date(month,day,year)
- C- 'I kyn l (0- .-- (��,
I/We certify under the penalty of perjury that th above an going irno;rr;a,;on is true and correct and that the applicant is a resident of Indiana and
owne /contract buyer of the aforementioned property on date application is filed.
Signatur_ owners full name IDate_(month,day,year))
/moo c d'�=� I 0 - 4 `3— HOC)
F SII re ent address of apply number and street,city,state,a dZr cod )
•doe 3_ • &� . � a C ii/ 1-17I6
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 oeriury can include imprisonment uo to two and a half years and a fine not to exceed$10.000.