HomeMy WebLinkAboutMortgage_Ricker (4) .,o,','N. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
' AFOR DEDUCTION FROM ASSESSED VALUATION
�` Gibson 0 2) 2021
State Form 43709(R14/1-20)
OTs Prescribed by Department of Local Government Finance
" '' R'ED
File Mark
INSTRUCTIONS: To be filed in person or by mail. I021 For filed with:
Filing Date: Form must be completed and dated in the calendar year for which the FEBdeeductiion is sought. 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)
Dakota J. Ricker and Lory B. Ricker
Taxing District Key number/legal description Record number ' Page number
^ 26-17-12-100-001.481-021 and 26-17-02-400-004.727-021 /
1��� Q I RICKER LAKE PHASE 1 Lot 35.123 AC 90 Z1 1 9
O PT SE SE&NE NE 11 3 12 3AC
�l
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the pplicant the sole
assessment date,current year assessment date,current year date of application leg r equitable owner?
$0.00 $51,561.40 Yes ❑ 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
FProperty ❑Annually Assessed
I , J .- p '" Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller -
Farm Credit Mid-America, FLCA FEB 1 ® 2�2�
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
1601 UPS Drive, Louisville, KY 40223
•
Name of assignee or other owner or holder of mortgage ArA i 4(rt4:,-.4d
GIBSU:z COUNTY p..i• ,TOR
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 deduc'•n b•en requested If yes,state amount of deduction
other county ❑Yes El No on property for 0Yes El No
in Indiana? current year.
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or c,nt - t indebtedness that is recorded in'Ehe 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
SignatureMou Aud't r• County Date(month,d 'year)
�' Gibson 2•10• /1°2A
I/We certify under penalty o rj that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner ontract buyer• th r entioned property on d- e appli`tion is filed.
Sign- re(o full < �ftd7ea ,
`
F. :'•entdress p•'-pplicant(number and street,city,state,and ZI•co,-)
7: 0 W. 500 S., Owensville, IN 47665
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)
The penalties for periury can include imorisonment uo to two and a half years and a fine not to exceed$10,000.