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HomeMy WebLinkAboutMortgage_George (2)--------------- County Township STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Union 2022 WM Z Gibson yFOR DEDUCTION FROM ASSESSED VALUATION xState Form 43709(R14/1-20) File Mark ,e,. ' Prescribed by Department of Local Government Finance o filed mail. with:unty Auditor INSTRUCTIONS: To be beiled in person andr by where the property ✓r County Recorder tmar dated in the calendar Auditor orCounty Recorder of the is sought. payable. Filing Date: Form must completedro ert taxes are first due and Must be filed or postmarked with the County is located on or before January 5 of the calendar year in which the p p Y See reverse side for additional instructions and•ualifications. liffiril page number Applicant(owner or contract buyer-see restrictions on reverse side) Mary A.GeorgeTaxi Key number I legal description 43 HIIICrest Add Is the applicant the sole Unionng Districtequitable owner? 26 19 18 301-000.341-026/Lts 36 Mortgage/Contract indebtedness unpaid as oflegal A as of Mortgage/Contract indebtedness unpaid as of date of application `�JYca 0 No Assessed value of real curtent yearry assessment date,current year $150,000.00 assessment date, if no, t is his If owned with someone other than spouse,indicate with om 00 If no,what is /her exact share of interest? _ I .e property in question:Annually Assessed indicate below: I:Real Property ElAnnually Assessed If name on record is different than that of applicant, Mobile Home(IC 6-1.1-7) Address of mortgagee or contract seller(number and street,city,state,and ZIP code) Na Main Street,PO Box 360,Jasper, IN 47546 JUL 1 3 2��7 Name of assignee or other owner or holder of mortgage 4. �� �i f of deduction Address of assignee(number and street,city,state,and ZIP code) T�,177 ��y`' tn Has this deduction be, I SCJ NO + anyIf yes,what county? What Taxing District? on property for �.�� CJ Does other applicantntyown property currentpro erty f O county Yes o e or contract indebtedness that is recorded in the county in Indiana? ep the recorder's office)that is the basis for the deduction. recorder'sA person is not entitledncluI. this dhome/equity line on unless tof credit that is aecolyded in the county re o der's office(including any COUNTY AUDITOR Deduction approved in the amount of: 20 20 20 20 20 Date(month,day,year) 20 20 County -- Auditor Gibson applicant is a resident of Indiana and Signature cf certify under that the above and foregoing is£iea true and correct and that the Date(month, 1,17) 1/We certify penalty of perjury on date applicationowner 1 contract buyer of the aforementioned property _ fa-—4-` /'`�� applicant(numb�=nd street,city,state,and ZIP code) IN 47648 Date(month,day,year) Full -sident-�ess of •Person Sine zed Street,Fort Bra h, 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 for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.