HomeMy WebLinkAboutMortgage_Scott (5) -*�* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
yl 'f� FOR DEDUCTION FROM ASSESSED VALUATION Gibson sville 2022
71 �) State Form 43709(R11 6-09)
%,�, Prescribed by Department of Local Government Finance RECEIVED 141b6 1
INSTRUCTIONS: 11 esk ►l • I' ' JUL 2 1 2022 File Mark
To be filed in person or by mail. �rWv`-
T
Filing Dates: 1.) Real Property: Must be completed and dat-• t e calendar year for which the deduction is sought. Form filed with:
Must be filed with the County Auditor or County Recorder of the county where the property is located Q CountyAuditor
on or before January 5 of the immediately succeeding calendar year.
2.) Mobile/Manufactured Home not assessed as real Property: Must file with the County Auditor of the County Recorder
county where the property is located during the twelve(12)months before March 31 of each year the
Ll deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer—see restrictions on reverse side) 2�00 bO�s g Z.3 - d 1---1' Kristopher Eric Scott and Alicia C.Scott 2,t'— (1_ ?)
Taxing District.2\ Key number/legal description Record nu ber Pa e In r
l *WINYARD PLACE 4 7/0
Assessed value of real property as of Mortgage/Contract indebtedness unpaid I Mortgage/Contract indebtedness Is the applicant the sole
March 1,current year as of March 1,current yea-j r. unpaid as of date of application legal or equitable owner?
$0.00 *$4'6 3Z'(., L7()a CO *$322,400.00 0 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
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller F I L FI D
* Caliber Home Loans,Inc.
Address of mortgagee or contract seller(number and street, city, state, and ZIP code)
1525 S.Beltline Road,Coppell,TX 75019 JUL 2 1 2022
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street, city,state, and ZIP code) //ztluzil & Lilo.- a.1
TY AUDpITOR
Does applicant own property in any other In yes,what county? What Taxing I9 M .N CO as this�educUon been requested on property
county in Indiana? for current year?
❑ Yes Or No Xs Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 I 20 20 20 20 20 20
Signature of County Auditor vsn @.-- ) County Datelo�t d „year},
I/We certify under the penalty of perjury that the above and for oing information is true correct and that the applicant is resid nt of Indiana and
owner/contract buyer of the aforementioned property on dat ppl'cation is filed.
0 s 6^ I Date(month, day,year)
Signatu (owner's full name) /x/Fy c (/L ��` to(month,
x �1, -
08/2022
Full resident address of applicant(number and street,city, state, and ZIP code)
* 9603 W 575 S,Owensville,IN 47665
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)