HomeMy WebLinkAboutMortgage_Cundiff (4) . e-*,-"*g,q, STATEMENT OF MORTGAGE OR CONTRACT IND.EBTEDN_ESS County Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION Gibson '!A' 2020
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;, � State Form 43709(R14/1-20)'WC"' NOV
Prescribed by Department of Local Government Finance 3.0 Z020
File Mark
INSTRUCTIONS: To be filed in person or by mail. FOSS Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. Ir I 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)
Jennifer M. Cundiff
Taxing District Key number/legal description Record number Palle number
Fort Branch 26-19-19 204-001.308 026/INDIAN HILLS 75 D-27 f2.40719 :556.3-2-
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?
$0.00 $144,000.00 Q 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 _ ___
F 4 eal Property ❑Annually Assessed
IL 4J _ Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Heritage Federal Credit Union - DEC 0 B 2020
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
5388 Old State Road 66,Newburgh, IN 47630
Name of assignee or other owner_nr_hnid -- 1 1'9
. 1
61BSON COUNTY Ai ' :l
obA,\(\e\q1
1 \� at Taxing District? Has this deducti n be , requested If yes,state amount of deduction
J on property for
in r\� current year? Yes No
A F I )balance on the person's mortgage or tact inde edness that is recorded in the county
rec I�' \� ;ecorded in the county recorder's offic )tha is the basis for the deduction.
� , COUNTY AUDITOR
DefjJ°
e. C1) . .
0.( �C� i��� — Du� 20 20 20 20
Sigr. ,� County Datemon�day,year)
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'' 1"I) I �- Gibson 1 ' ^-� �'V
I I We certify under penalty of perjury that the a foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
'g t wner's full name) Norkit5
'�
ND
ull sid t addressof app ant(numbei'and street,city,state, ZIP code)
78 45 E, Fort Bra'hch IN 47648
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)
—. ... - • _ _ __ _ '__,_._,_. ,____e .4 Pdn Ann