HomeMy WebLinkAboutMortgage_Blanton (4) E-„►4, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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y..,-,-,-",= FOR DEDUCTION FROM ASSESSED VALUATION
a`'"`"�► State Form 43709(R13/10-15) Gibson Washington 2020
':-' Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail. Form filed 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 ■❑ 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 for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
James & Lora Blanton
Taxing District Key number/legal description Record number Page number
Washington 26-05-57-084-000.562-017 2020 LIS kg
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?
$60,000 El 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: Is the property in question:Annually Assessed
pir eal Property ❑ Annually Assessed
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Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller E
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Address of mortgagee or conl o 91-v 4,g ol-g - AUG 2 7 2020 ,�V�
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Name of assignee or other ov Drawer1�O
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Address of assignee(number UN
Card NO. YAUo�rOR
Does applicant own property Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? Yes [ current year?
❑ ❑•Yes ❑No
A person is not entitled to this deduction unless the person has a balance on me 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
Signature of County Auditor County Date(month,day,year)
.A),,,,... g ., Gibson 08/27/2020
I/We certify under the penalty of perjury that the above and 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.
Zip,wner's full r ie) Date(month,day,year)
.„--.— n. 08/27/2020
ull r ent address of applicant(number and street,city,state,and ZIP code)
70; N. Shiloh Church Road, Hazleton, IN 47640
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 perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.