HomeMy WebLinkAboutMortgage_Lancaster (2) ,s'sTlz,,. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
r -,'--rj A. FOR DEDUCTION FROM ASSESSED VALUATION RECEIVED Gibson Montgomery 2022
.,,,`, State Form 43709(R14/1-20)
' Prescribed by Department of Local Gove ment Finance MAY 2 4 2022
(� File Mark
INSTRUCTIONS: To be filed in person or by mail. oV 4 ` •_A I It Form filed with:
Filing Date: Form must be completed and dated in the caler r year for which the deduction is sought. ACounty Auditor
Must be filed or postmarked with the County Auditor or County Recorder of 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. WI County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Teresa Lancaster
Taxing District Key number/legal description R cord number Page number
Montgomery 26-18-07-101-000.247-022/Pt NW 7-3-11 (0.20 A) 2_2- . 2_32G
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 legs o uitable owner?
$49,800.00 $100,909.00 es 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 he property in question:Annually Assessed
FILE Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
German American Bank MAY 2 5 2022
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 t-yj.,.- -e a, Y rJ' La,
GIBSON COUNTY AUDITOR
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own grope i ny If yes,what county?
What TaxingDistrict? Has this deductio been requested If yes,state amount of deduction
other county on property for Yes ❑ NO
in Indiana? ❑ Yes o current year?
A person is not entitled o this deduction unless the person has a balance on the person's mortgage or con ract 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 Da monM,ggy.,I(e6t)`Z�
n� &) Gibson 5 en V�� C�
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant Is a re ident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature(ownerr full name) �;(� I Date(mon�,day, era�r)r�
4/-t1�Q_ l`-'CO)1l0(1,A\Su S5 L Z-
Full resident address of applicant(number and street,city,state,and ZIP code)
405 E Clark Street,Owensville, IN 47665
Person authorized by duly executed Power of Attomey 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 imnrisrrnmo.+t...,s,......-....+"0-...If ^^.+^F.._