HomeMy WebLinkAboutMortgage_Johnson (17) . .7'0� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4 `$. FOR DEDUCTION FROM ASSESSED VALUATION REC t
9 .'3 State Form 43709(R11 6-09) Gibson �+��ens,,irre 2020
%. 9 Prescribed by Department of Local Government Finance `` `/
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INSTRUCTIONS: I o I S-C1,� File Mark
To be filed in person or by mail.
Filing Dates: 1.) Real Property: Must be completed and dated in the calendar year for which the deduction is sought. Form filed with: 1
Must be filed with the County Auditor or County Recorder of the county where the property is located
on or before January 5 of the immediately succeeding calendar year. County Auditor
2.) Mobile/Manufactured Home not assessed as real Property: Must file with the County Auditor of the County Recorder
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)
* Travis C.Johnson and Elizabeth G.Johnson
Taxing Dis t21 Key number/legal description rr {� 'oo Qp 21 Record number Pagee number
* WINYARD PLACE 37/38 2b -fl_V�^ 1—004•� l iL '�� 9-1
Assessed value of real property as of Mortgage/Contract indebtedness unpaid Mortgage/Contract indebtedness Is the applicant the sole
March 1,current year as of March 1,current year. unpaid as of date of application legal or equitable owner?
* $0.00 * $225,000.00 r� ��1/ '
* $ 2 C ) ,�� i 0 Yes ❑ No
If no,what is his/her exact share of interest? Ifwhom owned with someone other than spouse,indicate withr.� m
If name on record is different than that of applicant,indicate below: Is the property in question: Annually Assessed
❑X Real Property ❑ Annually Assessed
ILobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
* Hoosier Hills Credit Union jr,""
Address of mortgagee or contract seller(number and street, city,state, and ZIP code) NOVQ
* 630 Lincoln Ave,Bedford,IN 47421 NOV q. 19 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city, state,and ZIP code) c � t;
GIBSOI\ COUNTY Al lnITi OR .__i
Does applicant own property in any other In yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑ Yes ❑ No Yes ❑ No
COUNTY AUDITOR I
_1
Deduction approved in the amount of: I
20 2 20 20 20 20
Signature of County Auditor rill _ 1-3— County 1��11 Date,(i o th, ye
I/We certify under the penalty of perjury that the above and foregoing information is true�nd correct and that the applicant isla rest ent of Indiana and 1
owner/contract buyer of the aforementioned property on date application is filed.
i Signat (own 's f me) flontl5Year)
Full resident addre of applicant(number and street, city,sta 2, and ZIP code)
* 9921 W 575 S,Owensville,IN 47665
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)