HomeMy WebLinkAboutMortgage_Baim (2) 4/28/22,8:01 AM Mail-Logan Vickers-Outlook
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}, ,r' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CI —out
Township Year
FOR DEDUCTION FROM ASSESSED VALUATION Gs4n 024 2021
state Fonn 4 i.3709(R14 1-20)
r Prescribed by Department of local Government Flnancre ,.---_..._.,._._
File Mark
INSTRUCTIONS To be filed it person or by meld, Form rued with:
Filing Date. Fount must be completed and dated in the calendar year for which the deductron is sought 10 County Auditor
Must be filed w pcuNnarked with She 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 faxes are first due and payable
See reverse side for addltronal instructions and quahfrcations. .. .__
+.:'arrant(owner torntract buyer-sae restrictions on reverse side)
Baim,Aaron A/Tiffany J
lasing District .�.�. tce'y number/eat dexnptionv�.T��_.___._,_.. —_ Record number Page number
024 26-22-14-300-000.294-024 - 2021 6585 I
I Assessed vaitta rri rest property as Of --I-Mortgage i Contract indebtedness unpaid as of Mortgage i Contract indebterdness unpecd as of et the apporant the safe
i assessment dale,current year assessment date.current year date of application legit or equitable owner,
225,000 — ®Yes 0No
7tt no_ h to-wat his I her erase borne'
ms share or interest? ____ If owned with one other than spouse.indicaterr
with worn
.__. ..—__ __ -.__._._...__ u f tip _ cafe b - Is the property question Y
if name on record is dMetdl than that of appl+cant,ardiraM helOw: n -AnnuaA Assessed
El Real Property ❑Annually Assessed t t-7j
. Mobile Home(IC
i Name of mortgagee or contract sellerFILED
5th 3rd Bank
Address'of mortgagee or contract seller(number and street.dry state,and ZIP cads)
1
Name of or other owner or coder of mortgage APR 8 8 2022
1 address at assignee(mumble and street,city state,and ZIP code)
•Does apptiant own property i i It yes,what county? What Tarring District? Has the deduction been re 6 on
°Met°aunty j! on Y -��y� 1��Q G� tfl COUNTY AUDITOR
•in Indianan Yes No
A person is not entitled to this deduction unless the person hes a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorders office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deducbon.
COUNTY AUDITOR
-- .
Deduction
approved el the amount of' ___._._
20 --1- 20 20 20 _ 20 20 20
e of Garxtty .day,/ ,County Date(needyear)
AL2 . f It s!' Gson it/a(JQ
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/Jyi.r .r of the aforementioned property on date application is filed._._.�---
.'rsss of applicant(number and sheet.city.state.and ZIP code)
2356 W 1300 S, Haub, IN 47639
Persona thodred by duly executed Power of Attorney or by IC 6-1 1-12-0.7 --..� i Dale(month.day.year)
t
Address of authorized person (number and sheet.city.state,and ZIP core)
The penalties for perjury can include Imprisonment up to two and a half years and a fine not to exceed$10.000.
RECEIPT FOR HUNG STATEMENT OF MORTGAGE OR CONTRACT NIDEBTEDNESS
Name at applicant Name of mortgagee or contract seller
Bairn,Aaron A//Tiffany J 5th 3rd Bank
Dane lead(%�8/�J -
UI Amount d a.oabrd+ess TaX►'W D�tricY
225,000 024
Key number/legal description
26-22-14-300-000.294 024 __
Elk
IIII
___--
Yt/aReoOr Gnus Date(mon1� yQ Q-1
�� Gaon W Ar v
'GIBBON COUNTY AUDITOR
https://outlook.office.com/mail/inbox/id/AAQkADA5NmQ0MjIjLThhMDAtNDQzZS1 iM2RjLTQ20WM3MmazMjV kZgAQAM WdrLXaBYBHv1 CD0oV6LgU... 1/1