HomeMy WebLinkAboutMortgage_Hensley (6) s=` " w STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION Gibson Oakland City 2021
, ., State Form 43709(R14/1-20) RECEIVED
Prescribed by Department of Local Government Finance
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DEC 1 5 2021 File Mark
INSTRUCTIONS: To be filed in person or by mail. \ Form filed with:
Filing Date: Form must be completed and dated in the calenyear for which the deduction is sought. ►A 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. ii% ounty Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Zakeriah D. Hensley
Taxing District Key number/legal description Record number Page,number
Oakland City 26-14-18-201-000.105-007/Lt 28&Pt Lt 29 Harden Add No.2 r7 ,`:) 2 6 �t``�ttj a
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 lega�or uitable owner?
$127,600.00 $159,000.00 Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: I t property in question:Annually Assessed
Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Home Point Financial Corporation ISAOA/ATIMA
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
9 Entin Rd, Suite 200, Parsippany, NJ 07054
Name of assignee or other owner or holder of mortgage GS
EA
Address of assignee(number and street,city,state,and ZIP code) O
2 rT1 i.--.-.1
Does applicant own property in any If yes,what county? What Taxing District? Has this deducti n b en requested If yes,ctate adeduction
other county on property for
0 Yes 0 No Yes 0 N . es:,in Indiana? current year?
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or on ct indebtedrfe that Wpcorrlhe county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis p:n e derfttion._
COUNTY AUDITOR c
,
a
Deduction approved in the amount of:
20 20 cc..\,.....D.,
20 20 20 20 20
Signature of C-panty udia County Da; mo th a\�/'\\ (:) hnv.1 - ) S GibsonI/We certify under penalty of perjury that the foregoing information is true and correct and that the applicant is a reside t of Ind na and
owner/contract buyer of the aforementioned property on date application is filed.
•n-ur: ,,. ner's full name) Date(m t d$y,yeD
--=ni resident ad. -- .•-cant(number and street,city,state,and ZIP code)
905 N Main Street, 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)
The penalties for penury can include imnrisnnment tin to twn,n..r,siv„,,. ----a— ,_...__..._------,"'n nnn