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HomeMy WebLinkAboutMortgage_Butts (2) : � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year x *' .Z, FOR DEDUCTION FROM ASSESSED VALUATION ^ y) State Form 43709(R13/10-15) ' (/\ Gibson Q Year Z Z *".;,�t Prescribed by Department of Local G mment F'{Ya1Jn)ceA `J11 INSTRUCTIONS: )j A. l"ITV - 4. 1) I t 3)�,, File Mark To be filed in person or by mail. CM r Form led with: FilingDates: Real Property:Must be completed and dated i the calendar y ar for hi 1 the deduction is sought. 1) p CountyAuditor Must be filed or postmarked with the County Auditor or County Records f the county where the property is � 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) Joseph E. Butts Taxing District Key number/legal description Record number Pleffitimber Center 26-12-12-400-001.829-004 `-- 22- J Z. Assessed value of real property 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? $65,550.00 © 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: IE:i'FILE {p tl property^eatProperty in question:Annually Assessed �t7' ❑ Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller MAR 0 2 2022 German American Bank Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 231 W Broadway St, Princeton, IN 47670 ` ,et:' -, Name of assignee or other owner or holder of mortgage GIBSON COUNTY HU UJI TOR 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 deducti n en requested If yes.state amount of deduction other county on property for in Indiana? El Yes 0 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 o 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)that 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 1 1 `, . S /^,.� County t Date �nt- ay year)_ I/We certify under the penalty of perjury that the ve and foregoing information is ru and correct and that the applicant s a sident of Indiana and owner/contract buyer of the aforementioned property on date application is filed. Signature owner's full na e) Date(month,day.year) ul I resident address of applicant(number and street,city,state,and ZIP code) 93 N 550 E, Francisco, 47648 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 S10,000. RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Name of applicant Name of mortgagee or contract seller Joseph E. Butts German American Bank Date filed(month,d ar) Amount of indebtedness T T ♦r, Taxing District s 2 $65,550I.i.. l J l ' j er Keynumber/le son Uon 1' .�.0 22_ ��2 26-12-12-400-001.829-004 Signature of County Auditor/County Recorder t n � aN CountyScMAR 0 2 2022 Date nth,(pay,year)2- ,Gib GIBSON COUP f'' :._..,...i"OR