HomeMy WebLinkAboutMortgage_Schleter (3) • RECEIVED
.,-.4. , STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDP S County Township Year
,1i _ ks FOR DEDUCTION FROM ASSESSED VALUATION
-`''.- j ( 1-20) Gibson 00 1 202
day � State Form 43709 R14/
\ .a I
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be friedin person orby mail. C IIForm filed with:
Filing Date: Form must be completed and dated in the calendar ye/' -
for which the deduct is sought. m 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)
Jacob August Schleter and Sara Jo Schleter, husband and-wife
Barton 26-20-06-300-002.195-001 9-021
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?
$$348,800.00 I2JYes ❑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
®Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
German American Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
711 Main St., Jasper, IN 47546 I �, r,
Name of assignee or other owner or holder of mortgage Q
Address of assignee(number and street city,state,and ZIP code) a,�, tad a ,j,,
��'pML��Gr� COUNT�/(A(UDITOR
Does applicant own property in any If yes,what county? What Taxing District? • f s[fit' seduction be requested If yes,state amount of deduction
other county
in Indiana? El Yes ®No current year?for 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 Audito/�' , q County 1 Date(month day,year)
IU1vAVIV1 gso,1 ,- 19• 20Zl
1/We certify under the penalty of perjury that a above and foregoing information is t and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sig ture(ow erslull ne ) / Date(month,day,year)
ull resident address of applicant(number an street city,sta e, ZI code)
01/11/2021
5745 E 500 S, Francisco, IN 47649
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Dale(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.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortgagee or contract seller
Jacob August Schleter and Sara Jo Schleter eirialVmte. ank
Date filed( onth,day,year) Amount of indebtedness axi District
l .202 1 $348,80 0 , . ..i._-f ,B on
v rn
Key numb r/legal description /� �' 0
26-20-06-300-002.195-001 2 c 21 — ?A ti rn
�,-c.. .
Signature of County Audit r/ ountyRecorder County`' Date(mon ,day,year)ti2
.w.1Vlv.� 6 G'son � ®® 1. li o 0
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P,IJDI�'O�
GIBSON COUNT`'