HomeMy WebLinkAboutMortgage_Hightshoe (2) ,"—"`--' County Township Year
.7''r' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
y RECEIVED
R- '��y FOR DEDUCTION FROM ASSESSED VALUATION Gibson Princeton 2021
t. State Form 43709(R14/1-20)
p4 Y�;�<"`' Prescribed by Department of Local Government Finance DEC 2 0 2021
�,,.--- File Mark
o� 1 Form filed with:
INSTRUCTIONS: To be filed in person or by mail.
Filing Date: Form must be completed and dated in the calend year for which the deduction is sought. 121 County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property County Recorder
is located on or before January 5 of the calendar year in which the property taxes are first due and payable.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Gregory A. Hightshoe and Margaret A. Hightshoe Record number P ge rteimb_erg
Taxing District Key number/legal description nu
Princeton 26-12-18-101-001.830-028/Pt Lts 4&5, Lt 6 Laura E.Woods Add G-'
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is legalthe
eor equitablecntthe
sole
assessment assessment date,current year date of application
er?
$100,700date,currentyear $100,000.00 t'es ❑ No
$100 what is his0 //
If no, is /her exact share of interest? If owned with someone other than spouse,indicate with whom
Is the property in question:Annually Assessed
If name on record is different than that of applicant,indicate below: Mobile�/1 Real Property ❑ Annually Assessed
Name of mortgagee or contract seller FILEry
The First National Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) JAN O'�2022
1515 W 9th St, Mount Carmel, IL 62863 AN
_
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) GIBSON COUNTY AL;Li-I TOR
Does applicant own property in any If yes,what county? What Taxing District? • Has this deductio b n requested If yes,state amount of deduction
on property for Yes ❑ NO
other county ❑Yes NO current year?
in Indiana?
A person is not entitled o this deduction unless the person has a balance on the person's mortgage or c nt ct 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 ---1 20 —1 20 [---- 20 20 20 r
gall... CountyTl�atE ( h ay,ye,�ar-
Signature of Gounty Auditgf'�� ., I Il ,,,JJJ
` 1 ` Gibson
I/We certify under penalty of perjury that the abooregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed. Date(mpnth,r1�y,y�ar)
Si. ture- (owner's ull n;27 i� A lt/1/tip'/Full res' -nt addr ss pd (number and street,city,state,and ZIP c )
729 '7 all Street, Prin 4ton, IN 47670 l Date(month,day,year)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
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. /fir
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS DECP /ir �
Order No. Name of mortgagee or contract seller
Name of y A. Hightshoe I The First National Bank 0 7/M•
Gregory o and Margaret A. Hightshoe 21-11bted }D Taxing District ram/
Date filed(mOn k,day, ar Amount of indebtedne [J_1
eoional Titie ServicesPrinceton
Key number/legal description 2,-° 2-"", ^ 6 3 '-
26-12-18-101-001.830-028/Pt Lts 4 5 6 Laura E.Woods Ad A Alp n 2022 pate(month,day,year)
Signature of County,pyq�jjtor/ unt Corder J�1I1ru bs ,�- .�2- - - (33
� .` Gibson ``� Ir
GIBSON COUNTY Hi.:i i'tOR