HomeMy WebLinkAboutMortgage_Richeson (5) r 'T4). STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESSCountyTownship
rj�;� Year
°' ��a FOR DEDUCTION FROM ASSESSED VALUATION
5 ".1-' 1i State Form 43709(R14/1-20) Gson 017 2020
,aie-.x'.vv Prescribed by Department of Local Government Finance
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. IZ 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)
Richeson, Carrie Shon
Taxing District Key number/legal description Record number Page number
017 26-05-12-100-000.667-017 �-Q 21 ....Gt4
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?
65800 IlYes ❑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 ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
ETFCU
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) FILED
Name of assignee or other owner or holder of mortgage
DEC 282020
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 be�l rA s,state amount of deduction
other county on property �p�sC
in Indiana? ❑Yes ❑No currentyearB tiLY�e �` fJ�ITOR
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 Co uditor Coun Date(month,day,year)
C� l\
,� ( 12i28i2020
I/We certi er the pena f e ti at-the above and f regoing information rue and correct and that the applicant is a resident of Indiana and
owner/contracter of the aforem tic)/ d propertyn d a application is filed.
K Signature(owner's f�l lt
Date(month,day,year)
��41, ,fAtiC oc\y 12282020
Full resident addres'-d pplicant(number and street,city,stateZIP code) .
6337 N SR 65, Hton,)N 47640
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)
r�.,...,.....ra:...,s�.....:................i...�..:... ........a....a..�..,......a-.�...u..,...-.......a..17........A s.....,....,..J or,in nnn