HomeMy WebLinkAboutMortgage_Kell .-: STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
i '" FOR DEDUCTION FROM ASSESSED VALUATION
a_.>= `'/. State Form 43709(R14/1-20) Gibson Center 2022
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 liC
n is sought. Q County Auditor
Must be filed or postmarked with the County Auditor or County Recof 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. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Ana Gloria Kell and Raymond Clavin Kell
Taxing District Key number/legal description Record��7�renumber P e number
Center 26-05-35-400-001.451-004/Pt NW SE 35-1-10(14.263 ac) .2.e) P- O 4
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?
$191,900.00 $336,000.00 ❑Yes 0 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: Is a property in question:Annually Assessed
Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller l
German American Bank FIL I IJ
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
711 Main Street, PO Box 360,Jasper, IN 47546
Name of assignee or other owner or holder of mortgage
MAY 2 2022
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property In any If yes,what county? What Taxing District? !irtictitetteferngegitA9 If yes,state amount of deduction
county f3/"1-ts® LIDIdO
nt India? ❑Yes ❑ No rrent year? DIA person is not entitled to this deduction unless the person has a balance on the person's mortgage ndebtedness 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 Ar‘k.- _ I / County Da ten f 1�,Yegt1 r� .
�C.)�J�t.'"k (\ Gibson L Lv'G
I/We certify under penalty of perjury that t ove and foregoing information is true and correct and that the applicant is a radent of Indiana and
owner/contract buyer of the aforementioned property on date application is flied.
Signature ner's full name) ''�oA Date(month,day,year)
Full re ' nt address of applicant(number and street,city,state,and ZIP code)
4225 E 200 N, Princeton, IN 47670
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)
._. ... --_--,-----...,....L,.iw r.....,+o.......unt,. fn f,.a%one./a half%ware anrt a One not to arc-aari$10.000.