HomeMy WebLinkAboutMortgage_LLC (14) "L STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
Ili- It FOR DEDUCTION FROM ASSESSED VALUATION Gibson 0 2 z 2022
State Form 43709(R14/1-20)
' Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail. Fo filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. County Auditor I
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. County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
L&S INVESTMENTS LLC
Taxing District
Keynumber/legal description Record number Page number
Owensville 26-17-12-102-000.118-022/Parcel ID(s):26-17-12-102-000.118-022 cl�0o�{oZ- J9 .3
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of MortgageIapplication Contract indebtedness unpaid as of Is9 a appli tat the o sole
date of
assessment date,current year assessment date,current year
$0.00 $0.00 Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
s e property in question:Annu ly Assessed
If name on record is different than that of applicant,indicate below: Real Property 0 Annually Assessed
I J1■ Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller F IL -`Boonville Federal
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage AUG 2 5 2022
Address of assignee(number and street,city,state,and ZIP code)
],� 7`.�[irtd)
' r 2sehas( o- MOWER If yes,state amount of deduction
Does applicant own property in any If yes,what county? What Taxing District? GI PbPert�y forr
other county ❑Yes ❑ NO on current year? Yes CI No
in Indiana?
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or ont ct 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 I 20 I 20 I 20 I 20 I 20 20
ear)
Signature of County Auditor '91 per I Date(month,day,'/�p�
,,t_1 ��l•)p iC �� I County
Gibson
I I We certify lceertify underre�n`'altyy of perjury that the above and foregoing Information Is true and correct and that the applicant is a resident of Indiana and
own I co tract buyer of the afor entioned property on date application is flied. �
Signal e(ow ereDa (
full name) a
JJ�Full i sidenta ress of app'cant(number and street,city,state,and ZIP code) b
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 penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.