HomeMy WebLinkAboutMortgage_Harte (2) 06�,4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
ti FOR DEDUCTION FROM ASSESSED VALUATION
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} i.t, State Form 43709(R14/1-20) - _- Gibson Mackey 2020
�`''-� Prescribed by Department of l
pi-2-0 —" 56 70 File Mark
INSTRUCTIONS: To be filed in person or
Form filed with:
Filing Date: Form must be completed e Drawer NO iht.
County Auditor
Must be filed or postmarke there the property is
located on or before Janui: due and payable. ❑ County Recorder
See reverse side for additional instructions. Card NO.
Applicant(owner or contract buyer-see restricts
Jordan & Paxton Harte
Taxing District Key number/legal description Record number Page number
Mackey 26-20-14-301-000.004-002 0 QC 6Co 10
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?
$ 56,000 VIYes ❑No,
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
)14
If name on record is different than that of applicant,indicate below: ,.,,,, Is the property in question:Annually Assessed
,41r ®Real Property El Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller "l,;,,, 6
y
Heritage Credit Union OFC, `.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) ,�
Name of assignee or other owner or holder of mortgage G/RG�� ��nn-- ®�OO
C`OtriA. /, •
Address of assignee(number and street,city,state,and ZIP code) •„rj,
Does applicant own property in any If yes,what county? What Taxing District? Has this deductiofu een requested If yes,state amount of deduction
other county on property for in Indiana? Yes Vil 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 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,year)
,Ah,,,V-L �,,, 41.//1 Gibson 12/28/2020
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature;(�o n�s full name) 6j"� Date(month,day,year)
/e � �2---- - """" 12/28/2020
F II reaident address of applican number and street,city,state,and ZIP code)
760 S. Division St., 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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.