HomeMy WebLinkAboutMortgage_Armstrong (8) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County _ i Township i__..__.
FOR DEDUCTION FROM ASSESSED VALUATION --
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vAltegb;_ti State Form 43709(R14/1-20) Gibson "tatti7trof31 2'o.
1
Prescribed by Department of Local Government
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
See reverse sida for additional instructions and qualifications.
AppIir.ant(oi.r-neh or contract buyer-see restrictions en reverse.side.) _
? A- r Pr`5--ro
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,-faxing Distnct Key...,,oper/legal description -, I Record number I Page number---
/V10105p1Vle r`') ! <9 4-/7 -o 6'- oos- .5-7 7 -6 d 1 I 01 1 5-11 os-
7Aase.ssed value ofireal property as of i Mortgage i Contract indebtedness unpaid as of I Mortgage/ConCria-galindebtedness unpaid as of Is the eppiicantthe;PTo
assessment date, current year assessment date current year I date of application legal or equitable owner? 1
I 5-0 000 I E No 1
If ro v.,haI is his/her exact share of interest? ldtbmeoehanpouse indicate v.iith whom ----1
If name on record is different than that of applicant.indic.ale,beLow 'o property in question:Annually Assessed
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JAN 3 202 i[ Real Property [I]Annually Assessed
i Mobile Home(IC 6-1.1-7)1
I Name e'mortgagee orldOntract seller
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I F; (--.5 V Fcctes-0,\_ S003 ‘1•1)5 -Ro.f\X-- 1
Address of mortgagee or contract setIe7(huroter and saeet city state.and ZIP codni----- --E—Cf -4.•:?&
GIBSON COUNTY AUDITOR 1
Name of assignee or other otwner or holder of mortgage 1
5 766},1, - P
___.._____.._.. ___. ___
ATidT€3..;sl-Of assicnee bomber and street,city state and ZIP cede)
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Does applicant own property in any If yes what county? I What Taxing Diatrict?---- I Has this de ctliaS
'other county 1 !on property or y
PI K:1115-I lc-D 136 ,A."---,,we)5 --1
lin Indiana? ri Yes [K.I.4o I current yea . L •
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A person is not entitled to this deduction unless the person has a balance on the person's mortgage or co
recorder's office(including any home equity line of credit that is recorded in the county recorder's o e)
COUNTY AUDITOR
'Deduct-on approved in the amount of
______ x 1- 20
20_
20 20 ,
,
20
1 20 l 20
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si,,,,.,,me ..,,,,,:Auditor . I County , Date(month day year)
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1
________ )65Z)yl
,____ _
- I I We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a reside 4 -• :-.-- :•d
owner/contract buyer of the aforementioned property on date application is filed.
-S:goat 4,11 ,e-'s ft:Ill flare . Da5, -vanth day year)
',al `-.47".44-C, ti-- _63 — zo22__
F,-.7 .e.rs:de, a:dross of applicant( orn'aca-ads!reet city stat- and ZIP code) '
613 7S-S lb-75W 6 V/1-4-e: )JA
_______
Pe-son aathorlied 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 stete.and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S10:000.
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