HomeMy WebLinkAboutMortgage_Miller (46) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ounty Townshi Year
FOR DEDUCTION FROM ASSESSED VALUATION ��, ow 2022
i+\ P `' State Form 43709(R14/1-20) CI
File Mark
*be:_ - // Prescribed by Department of Local Government Finance
INSTRUCTIONS:
To be filled in person or by mail. Form filed with:
Filing Dates: Form must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the ✓yp\
property is located on or before January 5 of the calendar year in which the property taxes ae first due County Auditor
and payable. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Darren J. Miller and Jessica L. Miller
Taxing District 6 Key number 26-02-48-101-000.459-018 Record number Page number
as a3s13
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the ap 'cant the sole
assessment date,current year assessment date,current year date of application legal o equitable owner?
$447,659.26 Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is e property in question: Annually Assessed
Real Property ❑Annually Assessed
Mobile Home (IC 6-1.1-7)
Name of mortgagee or contract seller
Farm Credit Mid-America, FLCA FILED
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
12501 Lakefront Place, Louisville, KY 40299
Name of assignee or other owner or holder of mortgage
MAY 1 9 2022
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any If yes,what county? What Taxing District? Has th6 e64e�.'4 If yes,state amount of
other county on prop C LINTY ql int deduction
in Indiana? 0 Yes ElNo current year? Yes ZT
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or co tr t indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that i the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 I 20 20 20 20
Sign
�r�f County Au � p ,`e� . County ),_ScYr\
\ Date(month,da y$ar)�l ��I/WOe cee tif�fyy1�under the penalty of perjury that the above andegoinngformation is true and correct and that the a pllii�cantis/Va rresident of Indiana
and owner/contract buyer of the aforementioned property ate application is filed.
SigçorSe full ame) Date(month day year)uent add ss of applicant(number and street,city,state,and ZIP code)
2060 E Dea Level Rd., Hazleton, IN 47640
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.