HomeMy WebLinkAboutMortgage_Elmore (2) .Ma-t* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
e' '`":' % FOR DEDUCTION FROM ASSESSED VALUATION C unty Township/ rr�� /�Y-e�arq�
",,',�- '' State Form 43709(R13/10-15) �t�V,/'� 0 G rq--- '-°( r�'
;- ' ✓' Prescribed by Department of Local Government Finance Vr \ /
File Mark
INSTRUCTIONS:
To be filed in person or by mail. F rm r ed with:
Filing Dates.- 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County 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.
Applicant(owner or contract buyer-see restrictions on reverse side)
Elmore, Austin Ogly.
Taxing District Key number/legal description ord nt b Pa ero r
Pet i-0IhA k 26-04-36-200-001.049-027
Assessed value of real prope ,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 legal or equitable owner?
$299,500.00 IZJ 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
WI Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller F I T, i■■ �•�1 T^�
German American Bank ��■„-/�/
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
711 Main St Jasper, IN 47546 f EB 2022
Name of assignee or other owner or holder of mortgage y`��cc./[tG �,,,r,t
Address of assignee(number and street,city,state,and ZIP code) /'/he 2 1//K dJ
GIBSON COUNTY AU T
Does applicant own p perty in any If yes,what county? What Taxing District? Has this deductio b0 n requesy�d If yes,state amount of deduction
other county 6.... '�^V���G6 on rropyea for ,�(
in Indiana? Yes ❑No c,�1Y1 4� current earf es LYJ No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or ract 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 th a basis for the deduction.
COUNTY AUDITOR ('s
Deduction approved in the amount of: �•./�
20 20 20 20 20 20 20
Signature of County Auditor County \ Date(m t a 2
2-
,,We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant a re ident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signs re((ow
er'sfulll name) { Date(month,day,year)
/e1/t4 eE,!A,..^t -Qa,, 4- -5 -- 01/ 2022
Full r si ent address of applicant(number and street,city state,and ZIP code)
2 43 North Tower Lane Princeton Indiana 47670
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)
Tha npnaltip.e fnr Hari,,ry'an innl,ifla imnri.nnment on to two and a half vearc and a fine not M n'n nil!tin nnn