HomeMy WebLinkAboutMortgage_Browning . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
i' "" 1 ounty Township Year
4 -" FOR DEDUCTION FROM ASSESSED VALUATION
"` ji . ,g State Form 43709(R13/10-15) �/� ZO 20
•` 1' Prescribed by Department of Lo I Go er ment in A Vr t
INSTRUCTIONS: („ ,
• 1 File Mark
To be filed in person or by mail I 1' "_` Fo rled with:
Filing Dates: 1) Real Property:Must be completed and dated i the calendar yea for which the de ion is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the coun y 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)
Brian M Browning
Taxing District Key number I legal description . •nu er P-e-n}i@b� /-
Barton 26-20-02-201-002.173.001 (�JJ�/C�J,
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?
$110,400.00 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
FA Real Property 0 Annually Assessed
FMobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller ILE ^fGerman American Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 202�
711 Main St., Jasper, IN 47546 DEC
Name of assignee or other owner or holder of mortgage Address of assignee(number and street,city,state,and ZiP code) 42A4,4iVe-------
GIBSOd AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deductio ben requested If yes,state amount of deduction
other county on properly for Y
in Indiana? ❑Yes E No current year? Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or c n ct 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 th is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditoecel
; County l,--Yarl Dat (�nth d y,yeaA
I/We certify under the penalty of perjury that the above and foregoing information i tru and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature(owner' WI name) Date(month,day,year)
,__� 7 08/14/2020
Full resident address of applicant(number and strv, ate,and ZIP code)
4818 S SR 57, Oakland City, IN 47660
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 aenalties for neriurvr•an include imprisonment up to two and a half years and a fine not to exceed$10,000.