HomeMy WebLinkAboutMortgage_Curtis tr STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
-4. -;-,' , FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R14/1-20) Gson 028 2021
p*' - 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. I2j 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)
Curtis, Stephen B
Taxing District Key number/legal description Record number Page number
028 26-12-08-203-003.587-028 2004 4817
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?
15,000 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 propEerty in question:Annually Assessed
?Ilk,
❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller • �
Integra Bank F1 tom._..
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) JAN 2 5 2021
Name of assignee or other owner or holder of mortgage �j,, ' /��
Address of assignee(number and street,city,state,and ZIP code) I'/Lc� a S'852�
GIBSON COUNTY AUDITOR
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 Countyr ito County Date( o h,da ye r)
I/We certify under the penalty of perju hat e_ ove and foregoing information is tru d correct and that the applican is a resi ent of Indiana and'
owner/contract buyer of the aforemention erty on date application is filed.
Signature(owner' full name) Date(month,day,year)
Q/��` 1/25/2021
ull resident addresss f applicant(numbe�et,city,state,and ZIP code)
1908 Taylor Ave
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)
mmtlmdliiiiimga -- '-- •- °---- - a•.'- -h^If ar c and a fi
uP ne not to exceed$10,000. \