HomeMy WebLinkAboutMortgage_Sheraden ,,si q, STATEMENT OF MORTGAGE OR CONTRACT INDEBT ESS County Township Year
°} FOR DEDUCTION FROM ASSESSED VALUATION 1 ��EIVEb Z
State Form 43709(R13/10-15) MAY (�;\t`x'\ 00 r 2
�'• s'/ Prescribed by Depart ent of Local Government Finance 2 4 2022 . 1
R d T- V File Mark
INSTRUCTIONS:
To be filed in person or by mail. Form filed with:
Filing Dates: 1) Real Property:Must b=$•mpleted and dated in the calendar yea for hich the deduction is sought. y
Count Auditor
Must be filed or postm- ed with the County Auditor or County Reco d r of the county where the property is
located on or before January 5 of the immediately succeeding calen year. County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county
where the property is located during the twelve(12)months before March 31 of each year the deduction is sought.
See reverse side for additional instructions and qualifications.
• Applicant(owner of contract buyer-see restrictions on reverse side)
Sheraden,Heath A.and Michele L. tin
Taxing District Key number/lanai description Record number. Pageij uptherr
Francisco 26-13-19-400-000.234-005/N NE SE 19-2-9 1 AC C-1 D-7 `!7,0 [-Z� 2- 4
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of legals te ar pllli cant the owoll rt
e
assessment date.current year assessment date,current year date of application
58600.00 0.00 50.000.00 x Yes El 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 the property in question:Annually Assessed
x Real Property ❑ Annually Assessed
i L F, Mobile Home(IC 6-1.1-7)
Name of mortoaoee or contract seller
Regions Bank d/b/a Regions Mortgage ISAOA MAY 2 5 2022
Address of mortgagee or contract seller(number and street.city state.and ZIP code)
2050 Parkway Office Circle.Birmingham.AL 35244 4/'1_ ,h,,Zf 2 psy'..E1,Niicv
Name of assignee or other owner or holder of mortgage•
Address of assignee(number and street,city,state.and ZIP code) GIBSON COUNTY AUDITOR
Does applicant own property i any If yes,what county? What Taxing District? Has this deductio n requested If yes,state amount of deduction
other county on property for ElQ No
in Indiana? Yes )No current year? /y��[[peYes
• A person is not entitled to thi deduction unless the person has a balance on the persona mortgage or cokract 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 r� �a `(,��� County \ Date nth, y,y,L)
• I/ e certify under the penalty of perjury that the above and foregoing information is trtM and correct and that the applican s a sldent of Indiana and
o er/contract buyer of the aforementioned property on date application is filed. ,
• e(month.day.year)
to o ner's /name)
') --L
Full re ant address of applicant(number and street_city state.and ZIP codel
2155 S 650 E,Francisco,IN 47649
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 nenalties for penury can include imprisonment up to two and a half years and a fine not to exceed$10.000.