HomeMy WebLinkAboutMortgage_Minnis (11) Y,., STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Townshi Year
FOR DEDUCTION FROM ASSESSED VALUATION 0
i Gibson P— 2020
` .-..r State Form 43709(R14/1-20)
t•' ^.:: d' Prescribed byDepartment of Local Government Finance �-�K+�-
reie P �.9*P ED
File Mark
INSTRUCTIONS: (01\4 DEC 1 0 2020 Form filed with:
To be filed in person or by mail. f'(f
Filing Dates:1)Real Property:Must be completed a dated in the calendar year for which the deduction is sought. County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the /0 CountyRecorder
property is located on or before January 5 of the immediately succeeding calendar year.
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. I
1
Applicant(owner or contract buyer-see restrictions on reverse side) I
Philip M. Mite ,Amanda Redding
Taxing District �J ZQ Key number/legal description Record number Pagbl_
Pato#e— u 26-12-06-204-003.144-028 uS
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 lew•r equitable owner?
405,000.00 305,000.00 P. es 0 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: I s '-•-... 1...question:Annually Assessed
r 1 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
German American Bank DEC i 4 2020
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
711 Main Street, PO Box 360, Jasper, IN 47546 n/
Name of assignee or other owner or holder of mortgage I/
GIBSON COUNTY AtinITOR
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any If yes,what county? What Taxing District? Has this deduc,•n b--n requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes o current year? F�Yes ❑No
A person is not entitled to his deduction unless the person has a balance on the person's mortgage or on .ct indebtedness that is recorded in the county
recorder's office(including any home equity fine of credit that is recorded in the county recorder's offi -)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 Lun
20 20 20
Signature of County Audito ty Date( nth, a year)
1/0
-IJ We certifyunder the- nal of erju that the abreGe and foregoing information is tru d correct and that the applican is a Y sident of-Indiana and
tY P 1 rY 9 9
owner/contract buyer of the aforementioned property on date application i filed.
Signature(owne 1 n me) • Date(month,day,year)
Full resident address of applicant(number and street,city,st e,and ZIP code)
511 E Zimmerman Dr, Princeton, I , 47670
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 I Date(month,day,year)
Address of authorized person(number and street,city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S'10.000. 46791