HomeMy WebLinkAboutMortgage_Riggs 441-7"* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
t FOR DEDUCTION FROM ASSESSED VALUATION
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, , State Form 43709(R11 6-09) Gibson Oakland City 2021
-�'+ Prescribed by Department of Local Government Finance RECEIVED
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INSTRUCTIONS: (\ , FEB 2 4 2021 File Mark
To be filed in person or by mail. ` 1
Filing Dates: 1.) Real Property: Must be completed and dated in the calendar year for which the deduction is sought. For 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)
* Jon Riggs d*
Taxing District Key number/legal description Record numberPa a mber
Cibcon 00 * COLLEGE PARK 1-4 BLK 10 2-to'l3-13-�1o2^000,g08 4 "�21 �
Assessed value of real property as of Mortgage/Contract indebtedness unpaid Mortgage/Contract indebtedness Is the applicant the sole
March 1,current year as of March 1,current year. unpaid as of d e/�of application legal or equitable owner?
* $118,700.00 * $140,600.00 1V ❑x 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
EI Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller FILED
* 1st Source Bank
Address of mortgagee or contract seller(number and street, city,state,and ZIP code)
* 100 North Michigan Street,Suite 800,South Bend, IN 46601 FEB 25 2021
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street, city,state,and ZIP code) Aiued 62, A'ru: JrwJ
GIBSON CQUNTY AUDITOR
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?
El Yes No Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month, day,year)
I/We certify under the penalty of perjury that the above and foregoing information Is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Si•�%•,• ,• Date,'(rrorttlr,dad fear)
resident address of applicant(number and street, city,state,and ZIP code) �J {�
* 111 S.Third Ave,Oakland City, IN 47660
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)