HomeMy WebLinkAboutMortgage_Caalem 44+e "'�e STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
°/ '' FOR DEDUCTION FROM ASSESSED VALUATION r �^
"1'..:•.tl� State Form 43709(R13/10-15) r-R :G' R ` ' ‘County
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�� Prescribed by Department of Local Government Finance
IsfiiAc v' f 2 File Mark
INSTRUCTIONS: r V`\ fit,"
To be filed in person or by mail. Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is County Auditor
located on or before January 5 of the immediately succeeding calendar year. County Recorder
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.
Applicant(owner or contract buyer-see restrictions on reverse side)
Caalem, Romaricosofrontio and Caalem, Elena
Taxing District Key number/legal description 17:d u mil& Page n u,i4ig,-
Union 26-18-13-404-000.501-026 ((u-
Assessed value of real property as of Mortgage/Contract indebtedness uppppatal as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year asment ate,c urr //JJ��t,y�af�r� `4J date of application legal or equitable owner?
�� ❑ Yes ❑ No
If no,what is his/her exact share of interest? F I If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: I Tpro - on:AnnuallyAssessed
]_ j'
L W �J eal ■ nuallyAssessed
;� Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller •
Quicken Loans, Inc., ISAOA JAN 0.5 202%, JAN . 202k
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) _-
1050 Woodward Ave Detroit,AR 48226 '-
Name of assignee or other owner or holder of mortgage "" �J,, � /% �'t�',r
GIBSON I zeiL di. c • '-•,-
GIBSON COUNTY hUDlTOR
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 been requested If yes,state amount of deduction
other county on property for
in Indiana? Yes No current year? ❑El 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 d�i r �/ 1 , County Da a(nonth de y year) e.2. i
I/We certify under the penalty of perjury that the above an. . :.oi'g information is true n correct and that the applicant is a re,ident of Indiana and
owner/co r t buyer of the aforementioned property on date application is filed.
Signatur w er's ul me) Date month, yea
F II resident ddress pplicant(number and street,city,state,and ZIP code)
200 S ain St, Fort Branch, IN 47648
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)