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HomeMy WebLinkAboutMortgage_Schmitzerle ---. ..-i--• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS -44 County l Township Year jecli _ , FOR DEDUCTION FROM ASSESSED VALUATION k Nreitty.1!J Prescribed by DepartmentState Form 43709(R14/1-20) Gibson C_CD/- - 2020 \-- _----,;-.-- of Local Government Finance File Mark INSTRUCTIONS: To be filed in person or by mail. ---- Form filed with, Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. kj 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. CD County Recorder See reverse side for additional instructions and qualifications. [Applica towneripr.contract buyer-see res,..S3A)n ret:er . peria .._. IAssessed value of real property as of Mortgage/Contract indebtedness unpaid as of rigag ntract indebtedness unpaid as of Is the at p cantI the sole assessment date,current year assessment date,current year . plication °° legal or qu ble owner? i 'If no,what is his/her exact share of interest? If owns with ttisomeone,,ther than spouse,indicate with whom If name on record is different than that of applicant,indicate below, Is h property in question:Annually Assessed -- Real Property El Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortg gee or contract seller l?C.A.A ‘.. 1(--N .._._ -Address of mortgagee or contract seller(number and street.city state,and ZIP code) FILED- ------ Name of assignee or other owner or holder•f mart ag Address of assignee(number Gee 0 a . IP de) __ .__ __ NOV 3 0 2021 Does applicant own property in any If yes.what county? What Taxing Difftrict? Has this e r iriyhew 0 nro R ate amount of deduction z:!hine, county Li Yes 0 No ocunrreront'year? °t cRUN i °' 'a_ 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 I Deduction approved in the amount of: 1. 20 20 20 20__ 20 1 20 20 !Signature of County Auditor ,.. County qs!! Dct ( oeu,Sh darlez),2*.A. I/We certify under the penalty of perju at the above and foregoing information is tr and correct and that the applica t is a reF,ident of Indiana and 1 owner/contract buyer of the aforemen6o ate application is filed. Si--nature to er's ful name) Date(month,day.year) D --(30- zozi 1 Ful reskd ylf appIrct(num er and street„\ct and I code,) ck 1 s . 1 Person authorized by duly executed Paw° orney or by C 6-1.1-112-0 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 S/0,000.