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HomeMy WebLinkAboutMortgage_Parsons STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township • Yea (,.,:f_,.,..AFOR DEDUCTION FROM ASSESSED VALUATIONfi %•' b State Form 43709(R12/6-14) ��I ✓ Prescribed by Department of Local Government Finance REC��vE® S_Sc() Q Z� INSTRUCTIONS: LO ���� 1 itC JAN 2 8 2021 File.Mark To be filed in person or by mall. F rm filed with: Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought . Must be filed or postmarked with the County Auditor or County Recorder of the county where the property Is County Auditor located on or before January 5 of the immediately succeeding calendar year. County RecordE . 2) Mobile/Manufactured Homes not assessed as Real Property::Must file with the County Auditor of the county where the property is located during the twelve(12)months before March 31 of each year the deduction is sought. • , See reverse side for additional instructions and qualifications. _ Appli nt(owner orcpn�ct buy r- a restrictions on reverse de) iI� U rs Lr sr L. 1 t' viS b T�cing !strict Ke mbar/le al descri do Record number P - Assessed value of real property as of •Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness un aid as of Is the applicant the sole March 1,current year March 1,current year date of applicasien 9 O�O legal o e }able owner? �-Nes 0 Nt 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: r Is the property In question:Annually Assessed_ �i al Property ❑ Annually Assessed. r,,.:.4t.../ I,a. Mobile Home(IC 6-1.1- Name o mortgagee or contract sells -. .-->:,...:f• ' •• , -erg e ri c�(i�- �14 Address of mortgagee or contract seller(number and street,city,state,and ZIP code) •I r.• •• 1 i 1 Name of assignee or other owner or holder of mortgage4kte • Address of assignee(number and street,city,state,and ZIP code) GIBSON COUte Y A • 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 Tor in Indiana? ❑Yes 0 No _ currentt yea[t. .❑Yes 0 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 CountyI Date roith d a Signature oi County Autlit r Ls�� yl r� r j r�\ I/We certify under the penalty perjury penal of that the ove and foregoing information is u and correct and that the applicant i3 a resid nt of Indiana and _ owner/contract buyer of the aforementioned property on dajappiicat'. _ _filed._ ______ . ._ _• _ ----- . — Signature(owner's full no ) Date(month,day,year) u r dent address of applicant(number Ind street r di ;a UV lo S .3s )E.,. - . s N ���3q; 0000 Person authorized by duly executed Power cif 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. , r RECEIPT FOR FILING STATEMENT OF M.= • - - - - -• In, DEBTEDNESS . �, t Name of ap�licant� ` - e i y -•: -, •,. -ells F -�y LA ficcv) • An VOWC:ct)11 itt-A 'VYKSOCIA V° Date fil (month, y,year) Amount of in e�te�nsQ Taxing District • d'� C� 2,1-\ .,•_, Key nurngal desa6o9on / '—‘23— 0/2--rCSOQ—00\ .S. 1 ‘A a _firediodelAgL\ -3c ) _ Signature of County Auditor/County Recorder me N BOUNTY AU©1TOt3 Date(month,day,year) L•ockta. ".. -04-e— L • p8 6o jc I 7 �Ual&v/1/e w 4-270 to