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HomeMy WebLinkAboutMortgage_Dilbeck v > STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year a .--,,�� FOR DEDUCTION FROM ASSESSED VALUATION c� l� fe`= Gibson O L 2 24 11 State Form 43709(R14/1-20) "- "" __< Prescribed by Department of Local Government Finance +' y (r�^��/ j� r \ I File Mark INSTRUCTIONS: To be filed in person or by mail. \' i'._n I I ri! 'l ' 'Y l l \ ���NNN"`***^^^ Form filed with: Filing Date: Form must be completed and dated in the cale dar year f r 1 the deduction is sought. 0 County Auditor Must be filed or postmarked with the County Auditor or C unty 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) Logan Dilbeck �ct� Taxing District Key number/legal description Record number Porn, , Owensville 26-17-12-203-000.425-022 7i'+p 2 /c�G)—CC7-- Assexced value of real property as of Mortgage I 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? $106,200.00 ®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 ®Real Property ❑Annually Assessed FILED Mobile Home(IC 6-1.1-7) Name mortgagee or contract seller Heritage FederallCredit Union Address of mortgagee or contract seller(number and street,city.state,and ZIP code) 5388 Old State Hwy 66, Newburgh, IN 47630 DFC 0 2 2021 Name of assignee or other owner or holder of mortgage iy.� Address of assignee(number and street,city,state,and ZIP code) 1.�,C,r,�4t tZ2A. C.m" *G/r:.�.. GIBSON COUNTY AUDITOR Does applicant own property in any If yes.what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction other county on property for in Indiana? ❑Yes ©No current year? ❑Yes ❑No 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 Deduction approved in the amount of: 20 20 20 20 20 20 //( 20 Signature of County Auditor �s (C.:C County \ S On D�tg„(mj11.d"Y.Y ear) t t tsr I/We certify under the\\penalty of perjury that the above and foregoing information i tr a and correct and that the applicant's(a rrelsidenntt of Indiana and owner/contract buyer of the aforementioned property on date application is filed. Signature(owns s full name) Lit B Date(month,day,year) 't�U/i N!t�l/lt,'r/I{'_'',F�1�V/' 11/19/2021 Full resident ad ress f applicant(number and street,city,state,and ZIP code) 308 S Mill St., wensville, IN 47665 Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Dale(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 MORTGAGE OR CONTRACT INDEBTEDNESS Name of applicant Name of mortgagee or contract seller Logan Dilbeck H decal Credit Union Date filed(month,day,year) Amount of indFne Taxing District : .`. '^l _ `'� . - II Owensviller-^�f c Key number l legal description /^"^'�'2 t ,�` /^`� ZZ. 26-17-12-203-000.425-022 DEC U 2 2021 !/ ` o Signature of County Auditor/County Recor er' rounty Dater'(')month,day,year) c.-=--' i/�Gutr-C I..1 L r saJ ` t GIBSON COUNTY AUDITOR