HomeMy WebLinkAboutMortgage_Hunt (3) ,;..E.N, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear
C FOR DEDUCTION FROM ASSESSED VALUATION
i''° c i, State Form 43709 R14/
� * 1 c 1-20) ����p`�E� Gibson Center 2021
k•.'== Prescribed by Department of Local Government Finance
�ee
INSTRUCTIONS: To be filed in person or by mail. S Ou*0_✓) ,5v 1 FEB 1 7 2021 File Mark
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. vEr 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)
Janet E. Hunt
Taxing District Key number I legal description Record number Page number
Center 26-13-33-300-001 .817-004 apa/ 09.0x7a7(p
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?
0 227,000 228,000 DYes ❑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 t(1ProPertYinuestion.AnnuaflYAssessed q _
eal Property ❑Annually Assessed ^
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
First National Bank of Carmi FEB 181021
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
201 E. Main St. Carmi, IL 62821 y .,<?. ii,i(a/' .--ict)
Name of assignee or other owner or holder of mortgage GIBBON COUNTY AUL 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 deducti n b requested If yes,state amount of deduction_ _ .
•:other county on property for -
• in Indiana? -'❑Yes ®No current year? Yes Q No
A person is not entitled to this deduction unless the person has a balance on the'person's mortgage or on act indebtedness that is recorded in the-county -
,recorder's office(including any home equity line of credit that is recorded-in the county recorders 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 County itoc g
County 1 Date(month,day,year)
e\ Sof) 2- I $ •2-o21
I/We certify under the penalty of perjury that the above and foregoing information is0Je and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sig re(ow er's full name) I Date(month,day,year)
02-05-2021
Full re ident address of applicant(number and street,city,state,and ZIP code)
4386 S 750 E Francisco, IN 47649
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 perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.
•
RECEIPT FOR FILING STATEMENT OF MOR •, CO IEBTEDNESS
Name of applicant ,•, of o Magee nt= er-
Date filed(month;day,year)' Amount of indebte ness . Taxing District Q_
2'1$=ti02.-k 2Z B 1�:2021 d OL{ ��,
Key number/legal description _
MM N y-
VV� - - - - - O ~i 1
' 2(,i3--S3 r 3 ) .317 ^00 7, %� , , . �I .021 - �2t N
Signature of County Au itor/County Recorder C �� '�'' Date(month,day,year)
(V)Wfl�rd CS GIBS t5v ,-,U(viTOR
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