HomeMy WebLinkAboutMortgage_Whitfield t�F= � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Townshi Year
.§7Wk. FOR DEDUCTION FROM ASSESSED VALUATION y p
'r,: �� State Form 43709(R14/1-20) 26 024 2021
„' ;eie
'' Prescribed by Department of Local Government Finance RECEIVED
`1��)rn'� File Mark
INSTRUCTIONS: To be filed in person or by mail.� W't "\ 1 DEC 2 8 2020
Form file ith:
Filing Date: Form must be completed and 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 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)
Andrew J. Whitfield and Danielle N. Whitfield 26-'Z241-SO 0-c p 2_ q - O 1Lt
Taxing District Key number/legal description Record number • Page number
024 .n 1-024/PT W SW 7 4 11 66.84 AC D-2, Gibson County tg0 g 0 000o GOOIS
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?
$179,550.00 I21Yes ❑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: he property in question:Annually Assessed
Real Property ❑Annually Assessed
FiLF .� . Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller •
Field & Main Bank DEC 2 8 2020
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
P.O. Box 5 Henderson, KY 42419 , __--
Name of assignee or other owner or holder of mortgage °✓rr,:a
GIBSON COUNTY AUDITOR
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 deduction be requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes XNo current year? es ❑No
A person is not entitled tothis deduction unless the person has a balance on the person's mortgage o ontract 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 r 20 20 20 20 20
Signature of County Auditor ? County month,day, e r)
Yvu .11 �"o`'� Date�Z 2 2�
I/We certify under the penalty of perjury'th t the-i,t : s d foregoing information is tr a nd correct and that the applicant is,a reside t of Indiana and
owner/ ., tract buyer of the aforeme tionede-.' on date application is.filed___ - __ _
Signa e( er's f n Date(month,day,year)
\� 12/11/2020
bull residen ss of applicant m er and street,city,state,and ZIP code)
1172 outh 650 est, Cynthiana, IN 47612
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)
T(...........II:....f�....1:.....,..,..:.,,.h,.4...:... ..,....♦....4,.A.........J..1...If .............J.,L:..,.....4 t.............J NAn nnn