HomeMy WebLinkAboutMortgage_Miller (5) 9 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
i ''- tt FOR DEDUCTION FROM ASSESSED VALUATION
\ �r State Form 43709(R14/1-20) Gibson Oakland City 2022
1;,� ✓ Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail.
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. 10 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)
Mama Miller
Taxing District Key number/legal description Record number Page number
Oakland City 26-14-19-101-000.673-007 Q Q J RQg•
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applica t the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$ 142,600 RlYes ❑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: I Is the property in question:Annually Assessed
FI
LE
Real Property El Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Hometown Lenders (M &T Mortgage)
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) M^�R
Name of assignee or other owner or holder of mortgage 20��
Address of assignee(number and street,city,state,and ZIP code) O'I O
UNTY 4-44;42. C
t Tn
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 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 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 Auditor /� +1 County Date(month,day,year)
Q 1.i�, �_a �M� Jation(tiC( Gibson LA (,r. .,— •y���
I/ e certify under the penalty of perjury that the above and fgoin is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sign ure(owner's full name) Date(month,day,year)
; � � �7�?� -�p�— 't7/ — /� • �.
Fu reside t address of applicant nu ber and street,city,state,and ZIP code)
330 W Morton St., Oakland City, IN
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 I EB c
Name of applicant Name of mortgagee or s stMarna Miller Hometown LesVl Mortga�y
qj e) -
Date filed(month,day,year) Amount of indebtedness Taxing Dist' t `�
— 1�,—a a $ 142,600 Q }� d Clt�L
y
Key number/legal description P `!
26-14-19-101-000.673-007 //(��� Ik��se p�"(��
Signature of CountyAuditor/Cou Reco er County �iikei(f Ot nth,day,year)
\C-k-,Ar1 V � Gibson G\ ° ll�V (-- -