Loading...
HomeMy WebLinkAboutMortgage_Blanton (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year . FOR DEDUCTION FROM ASSESSED VALUATION 1. State Form 43709(R14/1-20) RECEIVED Gibson 0 2.-2_ 7,0 aa. ",01�=', Prescribed by Department of Local Gove ment Fin ce INSTRUCTIONS: To be filed in person or by mail. -' "' I f/ ��1 FEB 1 $ 2022 File Mark 1 Form filed with: Filing Cate: Form must be completed and dated in the Galen r year :r which the duction is sought. © County Auditor Must be filed or postmarked with the County Auditor or County Reco er 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 Recorder See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Bailey M. Blanton Taxing District Key number/legal description Record number Pa number Owensville 26-17-01-404-000.533-022 --)A22 1 lj Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I 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? $88,888.00 ©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 L F D ®Real Property ❑Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Bank of England Address of mortgagee or contract seller(number and street,city,state,and ZIP code) FEB 2 4 20Q 5 Statehouse Plaza#500, Little Rock, AR 72201 �_ { Name of assignee or other owner or holder of mortgage �� j/Le � (.12 CG� . .%id^'. .u.,...+" GIBSON COUNTY AUDITOR Address of assignee(number and street,city,state,and ZIP code) Does applicant own property in any If yes,what county? What Taxing District? Has this deductio een requested If yes,state amount of deduction other county on property for in Indiana? ❑Yes ©No current year? Yes ❑No A person is not entitled to this deduction unless the person has a balance on the person's mortgage or on act 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)the is the basis for the deduction. COUNTY AUDITOR Deduction approved in the amount of: 20 20 20 20 20 20 20 Signature of County Auditor County 1 Date.{ryto lb,day,Oar) OW 4A ti 2y \3On �/ C1VU Z A.x I i We certify under the penalty of perjury that th ova and foregoing information is t u and correct and that the applicant a resident of Indiana and owner!contract buyer of the aforementioned property on date application is filed. Sure(owner's full name) Date(month,day,year) igbCt A Qd� • f3Q _„f.,� 02/17/2022 Full resident eddies applicant(number and street,city,state.and ZIP code) 306 N 2nd St., Owensville, IN 47665 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) The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000. . RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Name of applicant Name of mortgagee or contract seller Bailey M. Blanton Bank of England Date filed(month,day,year) Amount of indebte Taxing District 1Tn '2 �,{j tZ 2 Owensville O° Cm7 Key number/legal description F815129E,1Jm 26-17-01-404-000.533-022 (� Q n 22 L) m G . Signature of County Auditor/County Recorder (' 1 / ` Fjsn IDow'ity4 z0za Data manlh,day.year) ci ,'(mil 1.-,JC�'(-ry",`t`�!-cam 'i- ' 2.7 — 2..2_ GIBSON COUNTY AUDITOR