Mortgage_Buchanan dam , STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
". � (R14 ) Gson 006 2020
1'',;��� State Form 43709 /1-20
„` --4- Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail.
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. Z 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. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Buchanan, Robert Lee
Page number
006 26-13-36-100-000.697-006 2020 2946
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?
44,236 ®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: ya p ipe ;in question:Annually Assessed
!i'e.jPry�erty ❑AnnuallyAssessed
.... w Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Farm Cr Mid Am DEC 2 1 2020
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage
004:41iWt--------
Address of assignee(number and street,city,state,and ZIP code)
GIBSON COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? Eyes ❑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 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 2 20 20 20 20 20
Signature of County Aud' County \ Date(month da,year)
,� \Z-2i-'1.0`�,-0•
I/We certify under the p alty of perjury that the above and foregoing information is tr ie ,�ond correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementione property on date application is filed.
i>Signr(ow r's•fu name) Date(month,day,year)
Full residentnt ad�f plican nu er and street,city,state,and ZIP code)
3796 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)