HomeMy WebLinkAboutMortgage_Hipp (5) %� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
.f . t FOR DEDUCTION FROM ASSESSED VALUATION
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. ...f.Ii State Form 43709(R14/1-20) Gibson Johnson 2022
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be bled 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. ® County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is County Recorder
located on or before January 5 of the calendar year in which the property taxes are first due and payable.
Sea reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Tony&Judy Hipp
legal District
Keynumber/I al description Record number Page number Johnson 26-23-17-200-000.637-024 2020 2557
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract Indebtedness unpaid as of Is the
applicant
pli able owner?sle
assessment date,current year assessment date,current year date of application egal
$240,000 Yes ❑No
If no,what Is his/her exact share of Interest? If owned with someone other than spouse,Indicate with whom
Is the property in question:Annually Assessed
If name on record is different than that of applicant,Indicate below: (Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Farm Credit-Mid America 14
Address of mortgagee or contract seller(number and street,city,state,end ZIP code) .41:1!)
Name of assignee or other owner or holder of mortgage A�o� 8 9 9>
Address of assignee(number and street,city,state,end ZIP code) SOM :-.,. <O
6` C` I-Y>
Does applicant own property in any If yes,what county? What Taxing District? Has
n property de furtion been rd t t(,�ydy--_� N-yes,state amount of deduction
other county Yes No current year? Yes 0 It O
In Indiana? ❑
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness'( .s 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 d=ductlon.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
County Date(month,day,year)
a
Signature of County Auditor . Q - a Q a.
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te' /W
tea.•X�L��-�_-1�) \}�� �� M Gibson `� c,
/We certify under the penalty of perjury that the above and f egoin ormation Is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on data application is filed.
n Date(month,da,yyhearr))i
S'.gnalure(owner's full rem _�t �/(A//t�/�/ O��rc-/ //�O
��� • •J �t 1.' /// l/ /
Full resident address of scent(number and slree,city,state,and ZIP code) L�
12254 S US Hwy 41, Haubstadt, IN 47639
Person authorized by duly executed Power of Attorney or by IC 8-1.1-12-0.7
I Date(month,day,year)
Address of authorized person (number end 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 S'1Q000.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant I Name of mortgagee or contract seller
Tony&Judy Hipp Farm Credit-Mid America
Ant of Indebtedness Taxing District
"1
Date Ned(month,day,ye- �0-,dar) i - Imou $240,000 Johnson
jj
Key number I legal description
26-23-17-200-000.637-024 I Data(month dax year)
Signature of County Auditor/County R er 'County
- `�(1 \L�/y� Gibson '—k— -CDZ-Z'