HomeMy WebLinkAboutMortgage_Downing STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County ± Township Year -1
FOR DEDUCTION FROM ASSESSED VALUATION
state Form 43709(R14/1-20) Gibson 0 21 2020
Prescribed by Department 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. .i) 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
J
See reverse side for additional instructions and qualifications.
Appli nt ruiner or c•-tract buyer- -restrictions err reverse. itile)
iTaxiAiksistrict Key number/I*.escription Record number Page number
I_
Arr 2 • • -----,di% I-1....2-44,a'di.- do' -616'47772—OG71/ G?Cle I 'S 5 SS —
iAsse ed val ff real pro• y as of Mortgage i Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the-•pli =tit the sole
m asse-sent•is -.current .r assessment date,current year date of application legal or-• itable owner?
,
! Yes 0 No
l---
If no,what is his/her exact share of interest? I If owned with someone other than spouse,indicate with whom
Ion .
If name on record is different than that of applicant,indicate belt —••erty in que ..:A u. Assessed
Propert . A u. y Ass ag.-•
Flom lir l 6 Ailin• 7)
Name of mortgagee or contract seller (77„.....-. _
,._....te
i Dr r
' " el- NO" ( Dec i . a
,
Address of mortgagee or contract seller(number and street.c
Card IN 0
Name of assignee or other owner or holder of mortgage - ..................... °Ai c.,,, ./_„1.S,I
1-4Vr)..•-Th'
Addre s assignee 'mber and s re it.sb te. ld IP cod:5,-c
9 6:? - .5 -/a ‘,p--- ..4z ••Oci,
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(1?,tct)es er ca=li t own property in any If yes.what county? What Taxing District? Has this deduction n requested If yes,state amount of deduction
tSJ
on property for
in Indiana? _ ri Yes CI NO current year? es 0 No
......
A person is not entitled to this deduction unless the person has a balance on the person's mortgage of contra 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 i e basis for the deduction.
IL.-.._ .... COUNTY AUDITOR
I Deduction approved in the amount of:
20 20 20 20 k.,. 20 20 20
Aill il,
1 sig iure fCm /ffat Auditor .. County Date km 1 Isla 7;6 2 1
c2 , ,, ,-- SloiN
I.04....
.i e certify under the penalty of perjury that the at:Oye and foregoing information"s tru and correct and that the applicant s a re 'dent of Indiana and
owner I contract buyer o he aforementioned property on date application is filed.
ature owner's full nom rate(month,day year)
. re ident address of applicantnumber and....sZeet.city state.and ZIP crle?
Yi 1c)(g(A fa q)k 1\-e_. ----\---43_q_l_b _
Person authorized by duly executed Power of Attorney or by IC 6-1.1-1 -0 7 - Date(month,day year)
jAddresOf authorized person (number and street.city state.and ZIP code)
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The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed 510,000.