HomeMy WebLinkAboutMortgage_Mahinay ���6°"Fo STATEMENT OF MURTGAGE UK GUN I KAU I INUEt3 I EUNIZ county I ownsnlp rear
i FOR DEDUCTION FROM ASSESSED VALUATION.4, Gibson 0 2-4 2020
Ry -j State Form 43709(R14/1-20)
sae Prescribed by Department of Local Government Finance RECEIVED
File Mark
INSTRUCTIONS: To be filed in person or by mail. 0.C� JAN 0.4 2011 Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. Q 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)
Lindsey N. Mahinay and Maleko Mahinay
Taxing District Key number/legal description cord nuPoge number
Trdtrbstadt 26-23-01-200-002.264-024/TWIN OAK LOT 11 'CJ/vn ' --
Assessed value of real prop rty 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 eV able owner?
0.00 $172,000.00 L�'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: lathe pr erty in question:Annually Assessed
LEDW�Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller q�
Heritage Federal Credit Union JAN 01 ZO0 c()s
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
5388 Old State Road 66, Newburgh, IN 47630 r, tom?, 1,_
Name of assignee or other owner or holder of mortgage � � �' :.�.
GIBSON COUNTY AUDITOR
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property iinn ny If yes,what county? What Taxing District? Has this deduction bee quested If yes,state amount of deduction
other county El Yes IW No on property fo Yes El No
in Indiana? current year?
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
Signature of Co dk r . County D to(m ,stay,year)
i 'C�ha� Gibson tO 74
I/We certify under penalty of perjury t at th and foregoing information is true and correct and that the applicant is a r side t of Indiana and
owner/contract buyer of the aforementi erty on date application is filed.
Signature o ner's full ame 1/ Date(moot ,day year)
Full resi address of appl cant(number and street,city,state,and ZIP code) N%-e I /cc ')/(--)
5149 E. 1050 S., Haubstadt, IN 47639
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.