HomeMy WebLinkAboutMortgage_Holmes (5) 4 � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
y FOR DEDUCTION FROM ASSESSED VALUATION �.C�I fE®
°" ; State Form 43709(RI1 6-09) Gibson Princeton 2021
'a Prescribed by Department of Local Government Finance O 20't1
'616 f �� i
INSTRUCTIONS: 1 t ij N T j- t. '(J� File Mark
To be filed in person or by mail. (� f
Filing Dates: 1.) Real Property: Must be completed and dated in the calendar year for which the deduction is sought. o filed with:
Must be filed with the County Auditor or County Recorder of the county where the property is located
on or before January 5 of the immediately succeeding calendar year. County Auditor
2.) Mobile/Manufactured Home not assessed as real Property: Must file with the County Auditor of the ❑ County Recorder
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.
Applicant(owner or contract buyer—see restrictions on reverse side) /�
* Christopher Holmes V 2'8
Taxing Distri Key number/legal descriptio 1 �y Record number P vieItsjler
* • * CLARKSVILLE 28 PT, Y-6 -) 2-j --4O I -00 !. ,Ja '*/'o2A
Assessed value of real property as of Mortgage/Contract indebtedness unpaid Mortgage/Contract indeb ness Is the applicant the sole
March 1,current year as of March 1,current year. unpaid as of ate lic� legal or equitable owner?
w
* $0.00 * $0.00 *- v))'' ❑Yes ❑No
If no,what is his/her exact share of interest? If owned with somedne 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
,...4,4,OR al Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller ..,(j --`"..
* Bank of England '' 01
Address of mortgagee or contract seller(number and street,city, state, and ode) .'11
* PO Box 3490,Little Rock,AR 72203 G/
Name of assignee or other owner or holder of mortgage CO
tJ '
Address of assignee.(number and street, city,state, and ZIP code) TY/IV�/r®4
Does applicant own property in any other In yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana?_ - - - - - for current year'? - -
❑ Yes 0 No Yes 0 No
COUNTY AUDITOR
Deduction approved in the amount of: -
20 20 20 20 - 20 20 20
—mc\
Signature of Crig (' County 30 Date(month, day,year)Ir 1
� 2 ' t• '�C.1
I/We certify der the penalty of pen • -t the above and foregoing information is tr and correct and that the applicant is a resident of Indiana and
owne ont buyer oft of ementioned o on date application is filed. -
g re ner's full me \ ,D,ate-(month, day,year)
FL dent address of applicant(number and street, city, state,and ZIP code)
* 405 S.Seminary Street, Princeton,IN 47670 - - - - -
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)