HomeMy WebLinkAboutMortgage_Linne (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Yea
t FOR DEDUCTION FROM ASSESSED VALUATION Gibson 1.✓a5k��ty�vh 202
's S .Fenn 43108(R13 t 10-15)
'- yr 7 Preaabed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be filed in person or by mail. Form filed with:
Filing Dates: 1) Real Property: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 property is ® County Auditor
located on or before January 5 of the immediately succeeding calendar year.
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the countyElCounty Recorder
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 or contract buyer-see restrictions on reverse side)
Ross Linne and Kaitlyn Linne
Taxing District Key number/legal description Record number Page number Wvalue of r Vag`LL O tel 26-05-01-200-002.758-017 2G22 2852_
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of date Is the applicant the sole leg
assessment date,current year assessment date,current year of application equitable owner?
$325,000.00 ® 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 the property in question:Annually Assessed
® Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name f mo n or contracteditseller F
E ED Western Indiana Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
949 W State Road 154,Sullivan,IN 47882
Name of assignee or other owner or holder of mortgage J U N 2 3 2022
Address of assignee(number and street,city,state,and ZIP code) ,,/L,-
Does applicant own property in any If yes,what county? What Taxing District? Has this de n re
,.t'4 z,Pt.cids�state amount of deduction
other countyin Indiana 0""‹ on propertyairC� TY AUDITOR
❑ No current yea s o
A person is not entitled to this deduction unisex the person hes a balance on the person's mortgage or contract indebtedness that is recorded do the az
recorder's office(itrclralirr0 any home equity tine of aedlt that is recorded in the county recorder's oUAce)Mat is the basis Act the deduction_
COUNTYAUDITOR
Deduction approved in the amount of:
20
20 20 20 County 20 Date(month,day,year)
20
Signature of unty Auditor certify
�v 6/e2 J��
Ms
/�� Gibson
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and owner/contra
buyer of the aforementioned property on date application is filed.
/ Y "'— 'Date(month,day,year)
Signatur (owner'sfuf[name \CF/ 6 )S�a l
� r— C t
Full rest'address of applicant(number and street,city,state,and ZIP code)
6849 N State Road 65,Hazelton,IN 47640
Date(month,day,year)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
Address of authorized person(number and street,city,state,and ZIP code)
The penalties Aar perjury am Maude imprisonment up to two end a hei years and a One not to exceed$10,000.