HomeMy WebLinkAboutMortgage_Dewig (12) t
si: STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
i Y�.' "• State Form 43709(R14/1-20) Gson 024 2021
'y'-- a" Prescribed by Department of Local Government Finance
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Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. ® 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. 0 County Recorder
See reverse side for additional insinrcfrans and qualioris.
Dewig,Keith A/Christie NI �<��
Taxing District Key number 1 legal description Record number Page number
024 26-19-32-101-000.740-024 2022 235
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of I Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
21.0 OOO 1 125.000 t OVOS ❑No
it no,what is his 1 her exact snare of intereste someone other man spouse,indicate with wnom
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
JAN 2 5 2022 0 Real Property
p rty El Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of n,ur p or contract sailer .,C a ,,/,,..`,`
T its Y A,UDIITCI
GIBSON COUNTY AUDITr1R
Addre of mortgagee or contract seller(number and sheet,city,state,andZ P code)
Como i e4se•n LAr,e.. +�P ham\-, 1 )J 41Ca3c1,
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city state.and ZIP code)
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Does applicant own property i any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? El Yes jV0 current year? ®Yes 0 No I
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract 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
20 20 l ' :
\{20 20 20
Signature of Ca ,(tudi�o �,.t ' 0 Co \ a i Date(7nt ,dqy, 2_
` .r.ic..c:.ii.y u„4'4(urz�.$46..4.11yivt t.,,ju,3- ..,__ u.,wc v:r°.•.i::y.,i a-- ..s.:cu1cG�.-I 4.O.{.f•.34.a,i..uPhrI;;.iz,...3 [J..ijt;••.- ,ai.,114.,,..a '
o er I ontract buyer of the aforementioned property on date application is filed.
ignatu (8 er' full na )
if F Date( th,
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ll re1s? rT of ap.•- nt(number and street,city,state,end ZIP code)
690 E Eisenha Ln, Haub, IN 47639
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Address of authorized person (number and street,city,state,and ZIP code)