HomeMy WebLinkAboutMortgage_Harpenau (4) o`Nbm1; STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
a�'i FOR DEDUCTION FROM ASSESSED VALUATION ®2� 2020
d� -. '1 State Form 43709(R14/1-20)
Gibson
of me_,`� Prescribed by Department of Local Government Finance RECEIVED
\^ File Mark
INSTRUCTIONS: To be filed in person or by mail.Q.SS( I DEC 0 8 2020 Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. 0 County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property
is located on or before January 5 of the calendar year in which the property taxes are first due and payable. 0 County Recorder
See reverse side for additional instructions and qualifications. -
Applicant(owner or contract buyer-see restrictions on reverse side)
Mickey G. Harpenau and Valarie J. Harpenau
Taxing District 1 Key number/legal description Record number Page number
nAC) 26-22-12-300-002.205-024/THE MEADOWS LOT 12(2.12 51- 5
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 equ owner'?ita le
ale
s 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
I Property ❑Annually Assessed
Mobile Home(IC 6 1.1-7)
. ; •
Name of mortgagee or contract seller F i i
Heritage Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) p E C ®� 2020
5388 Old State Road 66, Newburgh, IN 47630
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) GIBBON COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction b requested If yes,state amount of deduction
other county ❑YesO on property for Yes El No
in Indiana? current year.
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 0 N20 20 20 20 20
010
Signature of County A • r �y, / County q (mo ,da year
�' 1 1 Gibson 1
I/We certify under •-nalty of perjury that t e-•• e 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.
__Signature(owne s ful name r Date(month,day,year)
Full resident ress of applica t(number and street,city,state,and ZIP code)
1301 W.Cloverdale Ct., Haubstadt, IN 47639
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)
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