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HomeMy WebLinkAboutMortgage_Adkins i ' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year `� , FOR DEDUCTION FROM ASSESSED VALUATION State Form 43709(R14/1-20) Gibson Washington 2022 LiT -- Prescribed by Department of Local Government Finance File Mark INSTRUCTIONS: To be filed in person or by mall. Form filed with: 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. ❑ County Recorder See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Harold&Lucy Adkins Taxing District Key number/legal description Record number Page number Washington 26-02-27-200-003.517-017 2022 784 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? $ 152,000 ©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: r Is the ealproperty in question:Annuelly Annually Assessed rt Assessed 1■■ Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller . Rocket Mortgage Address of mortgagee or contract seller(number and street.city,state,and ZIP code) MAR 0 3 2022.ock.4_9. Name of assignee or other owner or holder of mortgage �scCvn Address of assignee(number and street,city,state,and ZIP code) GIBCnNt1JU Y AUDI QR Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction other co on property for in Indianua?nty ❑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 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 Deduction approved in the amount of: 20 20 20 20 20 20 20 Signature of County Audits County Date(month,day,year) 4( .k.t ?� ex . \•.1_,.`'�,, ,+ •b�� Gibson -. _ Qc�c I e certify u •: the penalty of perjury that the above and forego' information is true and correct and that the applicant is a resident of Indiana and owner/cont --ct buy= of the entioned property on date application Is filed. Signature(owner s fun ne ,) -- Date anth,day, r) Full resident ad, -- •f appll and street,city,state,and ZIP code) 2597 E G • Road Hazlet , IN 47640 Person authori =•by duly ecu ower 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)