HomeMy WebLinkAboutMortgage_Dyke (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS i r sear
s' ,' FOR DEDUCTION FROM ASSESSED VALUATION -
' ; State Form 43709(R14/1-20) RECEIVED Gibson I O`� 2022
' % Prescribed by Department of Local Government Finance I i
INSTRUCTIONS: To be filed in person or by mail.
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OCT 2022 File Mark
1 iVetlC�i Form filed with.
Filing Date: Form 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 iK County Auditor
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)
JASON W.DYKE
Taxing District Key number/legal description Record number Page number
023 26-11-12-101-002.838-028 �1 Z - —I 1,
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
121,500.00 ❑ No
If no,what is his/her exact share of interest? T If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: F I E / Is the p perty in question:Annually Assessed
QM-Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller O C T 1 4 2022
HERITAGE FEDERAL CREDIT UNION
Address of mortgagee or contract seller(number and street,city,state.and ZIP c e) Jj�
5388 Old State Hwy 66,PO Box 189,Newburgh,IN 47630 -tam a t 4 -
Name of assignee or other owner or holder of mortgage GItsSON COUNT't AUDIT-
Address of assignee(number and street.city,state,and ZIP code)
fill
Does applicant own property in y If yes,what county? What Taxing District? Has this ded , b -n reque If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes No current year? PA Yes o
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or on =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 20 20 4920 20 20 20
Signature of County Auditor �, ` ` �� County \ f\ Date(fionth, ay,year)
-7,02.z. .
I,We certify under the penalty of perjury that the above and foregoing information is e and correct and that the applican is a esident of Indiana and
owner/contract buyer of the aforementi ned property on date application is filed.
Si nature full name) Date(month,day,year)
�N W March 31,2022
ul esident address of applicanti (numbe d street,city,state,and ZIP code)
308 N Sixth Ave,Princeton,IN 47670-1037
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month.day,year)
March 31,2022
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.
RECEIPT FOR FILIN5 �`-7 AGE OR CONTRACT INDEBTEDNESS
Name of applicant a of mort agee or contract Iler c
JASON W.DYKE e� C • `SA/ 1 W\
O 33
Date filed(month,daycr�1�r� Amount of OCTebyte4 ZW(��I�rr Taxing District r�Q n 0
l ` 1 YL1'500.00 �i0 _.
Key number/legal desc ption - fz1
26-11-12-101-002.838-028 6/t�.e( Q Y ` 2 ,0'L - N Q
Signature of County Auditor/County Recorder (GI) GIBSON COUNT' AUDII'F Y Date( `� th, ay,year)
On 0-✓t\fv„v q S -'PN 11fl 1 y�-1/c)-1,Z