HomeMy WebLinkAboutMortgage_Neidigh /f�-=,�:� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS aunty Township Year
I FOR DEDUCTION FROM ASSESSED VALUATION RECEIVED �0 0� 9
--, r' State Form 43709(R13 i 10-15)
i 1�; Yj.'/ Prescribed by Department of Local Government Finance JAN 0 U c 2022
INSTRUCTIONS: I File Mark
To be filed in person or by mail. �1J���YYY�� Form ed with:
Filing Dates: 1) Real Property.'Must be completed an dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the ounty Auditor or County Recorder of the county where the property is County Auditor
located on or before January 5 of the immediately succeeding calendar year. County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county
where the property is located during the twelve(12)months before March 31 of each year the deduction is sought.
See reverse side for additional instructions and qualifications.
Aoplicant(owner or contract buyer-see restrictions on reverse side)
Neidigh,Heather Dawn .
Taxino District'1 Key number/'eclat description ecord numb Pnuglr
Uni 1 1 26-18-13-402-000.228-026/CHRISTISON ADD 11/13PT/14PT PT SW SE 13 3-11.04 AC t(Jr,,,, �`QQ//
value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
ass.eCS!,Ba it date,current year assessment date.current year date of application legal or eauitable owner?
133900.00 109900.00 106.837.00 tt 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
F I .,..fr.....,
., x Real Property D Annually Assessed )
Mobile dome(IC 6-1.1-7
Name of mortgaaee or contract seller
Equity Prime Mortgage.LLC A
Address of mortgagee or contract seller(number and street,city state,and ZIP codesIAl`tN
PO Box 1194.Snrinefield.OH 45501-1194
e
Name of assignee or other owner or holder of mortgage t.. .f t_.-. .#�,-�. -, 1
GIBSON COUNTY AUDITOR
Address of assignee(number and street.city state.and ZIP code)
Does applicant own prope in coy If yes.what county? What Taxing District? Has this deductic n requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes Ill No current year? Yes ❑No
A person is not entitled to this •eduction unless the person has a balance on the person's mortgage or t 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's the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 g
20 20 20 20
Signature of County Aud qf ( �� County `� Dat ( nt ear)
c -c\
I f We certify under the penalty of perjury that the above and foregoing information is t ue nd correct and that the applican is a esident of Indiana and
r-/contract buyer of the•aforementioned property on date application is filed.
Sig tun wner's f I meks (mont ,day. ea)
uli rest ent address of applicant(number and street.city.state.and Z P code)
406 N West St.Fort Branch.IN 47648
Date(month.day.authorized by duly
executed
ly executed Power of Attorney or by IC 6-1.1-12-0.71 year)
Address of authorized person (number and street,city state.and ZIP code)
The nenalties for oeriury can include imorisonment!Mtn twn and a half roars aorta fir,..,r,t t.,o..,,00rt can nnn