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HomeMy WebLinkAboutMortgage_Schmitt (25) ^-h4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year 'l FOR DEDUCTION FROM ASSESSED VALUATION Gson 025 2022 State Form 43709(R14/1-20) �� :elk ,^ -* Prescribed by Department of Local Government Finance I v 1 /�VFile Mark INSTRUCTIONS: To be filed in person or by mail. S--}�, /• 1/1�') G)14 2J2Z Iv`� "L Form filed with: Filing Date: Form must be completed and dated in the calendar year for which the deductio is sought. 121 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. See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Schmitt, Gary J/Mary Jo Taxing District Key number/legal description Record number Page number 025 26-19-29-400-002.192-025 2022 515 Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the e soleo Is assessment date,current year assessment date,current year date of application gequitable er? 115,000 Ell 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: F T 1 ED Is the property in question:Annually Assessed ®Real Property ❑Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller APR 1 4 2022 ETFCU Address of mortgagee or contract seller(number and street,city,state,arykc=1 /7 i Ard GIBcON COUNTY AUDITOR Name of assignee or other owner or holder of mortgage 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 deduction been requested If yes,state amount of deduction other county on property for IZI Yes 0 No in Indiana? ❑Yes ❑No current year? 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 County Date/(.m ir)22 ' (VI Gson `1 l �.)VG`l' 1,We certify under the penalty of perjury tha a above and foregoing information is true and correct and that the applican is a r Ident of Indiana and owner/contract buyer of the aforementioned prope on date application i filed. Signature(owner's full name) Date(month,day,ye r) ©V//o7 Dv7g. Full resident e f appli nt(number and treet,city,state,and ZIP d 1248 9 S, Haub, 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) The penalties for perjury can include imprisonment up to two and a halVyears arra'a+fine,/9 t•t errwPd$10..000 RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Name of applicant Nfirree or contract seller Schmitt, Gary J/Mary Jo n� Amount of indebtedness Ta g District Date filed(month,day ear) L..-�' 25 L\-\y_" 115,000 Key number/legal description APR 1 4 2022 �22-5 S� 26-19-29-400-002.192-025 I Datet(�ntt�tay, ea r Signature of County Auditor/County Recorder unt "f y -^ GL-. LY.46maJ GIB OUNTY AUDITOR