HomeMy WebLinkAboutMortgage_Rodgers (3) '-Y�, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
' FOR DEDUCTION FROM ASSESSED VALUATION Gibson Haubstadt 2022
a State Form 43709(R11 6-09)
..y �,, Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be filed in person or by mail.
Filing Dates: 1.) Real Property: Must be completed and dated in the calendar year for which the deduction is sought. Form filed with:
Must be filed with the County Auditor or County Recorder of the county where the property is located Q County Auditor
on or before January 5 of the immediately succeeding calendar year.
2.) Mobile/Manufactured Home not assessed as real Property: Must file with the County Auditor of the County Recorder
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—seelstrictions on reverse side) /
* Ginger Rodgers ( 0 ^'-7�-Z '� I — —(00 JC�C,I• L-4Z-—V "-1
Taxing District Key number/legal description Rec rd nu er Page number
* *PT NW 12411 1.00AC * l rta
Assessed value of real property as of Mortgage/Contract indebtedness unpaid Mortgage/Contract indebtedness Is the applicant the sole
March 1,current year as of March 1,current year. unpaid as of date of application legal or equitable owner?
* $0.00 *$e'eA 0 q Li-2...•00 *$219,942.00 lJ Yes 0 No
If no,what is his/her exact share of interest? If owned with someone p i with whom
If name on record is different than that of applicant,indicate below: Is the pro lr i sti�ssessed
Si Real Property 0 Annually Assessed
FEB 2 �gt)j14.a-tome(IC 6-1.1-7)
Name of mortgagee or contract seller LULL
* United Wholesale Mortgage,LLC ISAOA/ATIMA '� 1
Address of mortgagee or contract seller(number and street,city,state, and ZIP code) y�_ 4�, nun
* P.O.Box 202028,Florence,SC 29502-2028 G/Lc ON C
Name of assignee or other owner or holder of mortgage
GIBBON COt►... AUDITOR ,
Address of assignee(number and street, city,state,and ZIP code)
Does applicant own property in any other In yes,what county? What Taxing District? Has this deduction been q sted on property
for current year?
county in Indiana? Yes 0 No
0 Yes PrNo
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20
20 _
udita County Date(month, day,year)
Signature of Cou y /��i// lt5 i�'I .�/r 'rJ/C)' -
1 1 We certi nder the penalty of pe. that the above and Zgoing information is true and correct and that the applicant is a resident of Indiana and
owner/co tr buyer of the of entioned property on date application is filed. Date(month,day,year)
Sign
.K.'re ful n 02/15/2022
Full resi ent addres applicant(number and street,city,state,and ZIP code)
* 10862 S 150 W,Haubstadt,IN 47639
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)