HomeMy WebLinkAboutMortgage_Englert (3) .MER�, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear
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:.���a FOR DEDUCTION FROM ASSESSED VALUATION
i''`i'` 't State Form 43709(R14/1-20) Gson 009 2021
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`%� Prescribed by Department of Local Government Finance
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File Mark
INSTRUCTIONS: To be filed in person or by mail.
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. IZI 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
Englert, Wanda S
Taxing District Key number/legal description Record number Page number
009 26-23-06-200-000.794-009 2020 5751
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?
53,600 lZYes ❑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: Is the property in question:Annually Assessed
':=��roperty ❑Annually Assessed
FIL -4 i Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller -
5th 3rd Bank -
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) JAN /t Q 2021
Name of assignee or other owner or holder of mortgage IV l/ 67 /
Address of assignee(number and street,city,state,and ZIP code) GIBSON l;'iu r.i i S ^,.. "OR
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? ®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 CoutltvlW�tor �( r\�� County Date(month,day,year)
V +/I\ W Gson 01/08/2021
I/We certify under the penalty of perjury that t and foregoing information is true and correct and that the applicant is a resident of Indiana and
o er/contract buyer of the of ementioned property on date application is filed.
Sigh re(ow is fu I na a Date(month,day,year)
01/08/2021
Full resident address of applicant umber and street,city,state,and ZIP code)
525 S 8th Ave, Hau , 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)