HomeMy WebLinkAboutMortgage_Meeks (2) 0En,*Q� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
°it :2'''' FOR DEDUCTION FROM ASSESSED VALUATION
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"� •,:�' State Form 43709(R14/1-20) ,,
Prescribed by Department of Local Government Finance
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File Mark
INSTRUCTIONS: To be filed in person orbymail.
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 restrictio s on rev rse side)
J 1� / ( ecol Ch is .rMe .
Taxing District Key num er/legal description Record number Pag nu ber
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the a' 1' ant the sole
assessment date,current year assessment date,current year date of plication legal or itable owner?
}� 1 Yes ❑No
If no,what is his/her exact share of interest? If owned with so Bone otkl'er than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: I e property in question:Annually Assessed
eal Property ❑Annually Assessed
ri>o,A �If � Mobile Home(IC 6-1.1-7)
Name of rt9e or ontrac seller x
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
NOV 2 4 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) 0144.-S ]""r
GIBSON COUNTY UDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction b n requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes ❑No current year? s ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or ontra t 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 offic )that the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of: •
20 20 20 20 20 20 20
Signature of Coun ud' r County l Date(month,day,year)
11
I/We certify under the penalty of per) above and foregoing information is t and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
4 Signature own s fu n, Date( nth,day year)
FuIJ resident ddress of applicant( mQbeand str et,city,staf nde)
Person authorized by duly executed Power of Atto ey or byJ/C 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,city,state,and ZIP code)