HomeMy WebLinkAboutMortgage_Davis (38) .0,-.5>f STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
ii�' ' � FOR DEDUCTION FROM ASSESSED VALUATION �' Township Year
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"-,,..,1=')' State Form 43709(R14/1-20)
4° Gson
,,,s Prescribed by Department of Local Government Finance 027 2020
INSTRUCTIONS: To be filed in person or by mail, File Mark
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. Form filed with:
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is
or
located on or before January 5 of the calendar year in which the property taxes are first due and payable. 0 County o
See reverse side for additional instructions and qualifications. ❑ County Record
Recordrder
Applicant(owner or contract buyer-see restrictions on reverse side)
Davis, James B/Ashley B
Taxing District Key number/legal description
027 26-12-19-400-004.123-027 Record number Page number
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid 2020
as of is the applicant5969thsole
assessment date,current year assessment date,current year
date of application
51,000 legal or equitable owner?
If no,what is his/her exact share of interest? RI Yes ❑No
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
®Real Property ❑Annually Assessed
Name of mortgagee or contract seller ; Mobile Home(IC 6-1.1-7)
ETFCU ' !(
....i-J�;L..._ ll'r
,511
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage DEC 2 3 2020
•Address of assignee(number and street,city,state,and ZiP code) •P
GIBSON COUNTY`
Does applicant own property In any If yes,what Coun A ��R
other county tY7 What Taxing District? Has this deduction been requested If yes,state amount of deduction
El Indiana? Yes ❑No on property for
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 fine of credit that is recorded in the county recorder's office)that is the basis for the deduction.
Deduction approved in the amount of: COUNTY AUDITOR
Aft
20 Ir 20 20
20 20 20 20_
Signature of County'1.•tor
• I II .' County Date ont
ll (310 az)
I/We certify under the penalty of pew!* �' the above and foregoing information is true an e t and that the a
owner/contract buyer of the aforementioned property on date application is filed. pplicant i a reside of Indiana and
SigfiataTe(owne
l MEE Date(month,day,year)
Full resident add ass o app w n !:',��u� street,city,state,and ZIP code) 3Z 0
395 E 200 S, •''ton, IN 47670
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 penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant
I/4 e}�f mortm g :ohcoNtr ct seller
Davis, James B/Ashley B
Date filed(month,da � rzTiC Jk'y,year) Amount of indebtedness
1 /2412020" 12 25t Taxing District
Key number/legal description S 1'�rL 027
1 1
26-12-19-400-004.123-027 _ 'O 2Q— s% I
I
Signature of County Auditor/ ecorder
i
r, Date(month,day,year)
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