HomeMy WebLinkAboutMortgage_Rose (4) 6,i.,.a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4 j, FOR DEDUCTION FROM ASSESSED VALUATION
iy) State Form 43709(R14/1-20) RECEIVED Gibson 2022
ti Sty.,
Prescribed by Department of Local Government Finance
INSTRUCTIONS:To be filed in person or by mail. NOV 0 1 2022 File Mark
F m 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 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)
BRADLEY S.ROSE
Taxing District Key number/legal description Record number Page number
U`� 26-06-07-100-000.534-017 20 2 2 y b 2-
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assa„sment date,current year assos-,vent date current year date of application legal or equable owner?
_ 130,000.00 1 i Yes F J No
If no,what is his/„er exact share of interest? If..wns.J wit,ry meone 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
--_ - •p-, , J Ily Assessed
• - Home(IC 6-1.1-7)
Name of mortgagee or contract seller
NAVY FEDERAL CREDIT UNION
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) N0\1 0 1 ZOLZ
5550 Heritage Oaks Drive,Pensacola,FL 32526 11 V
Name of assignee or other owner or holder of mortgage _.1/;,„„)
tiik a„. �� 'TOR
Address of assignee(number and street,city.state,and ZIP code) GIBS°
Does applicant own property in any If yes,what county? What Taxing District? Has this n en reque If yes,state amount of deduction
other county on property or
in Indiana? ❑Yes �`Alo current year? Yes No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or o ract 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 20 20 20 20
Signature of County Auditor ` g
County \ Date(mo th,d y Year)
� ..Suer\ ZL-
I/We certify under the penalty of perjury that the above and foregoing information is tr nd correct and that the applicant i a re ident of Indiana and
owner/contract buyer of the aforementi•.-• property on date application is filed.
Signature(. . e s -e- llr / Date(month,day,year)
a - October 6,2022
Full residenr2ffdress of applicant(nu and street.city,state.and ZIP code)
5620 E 600 North,Patoka,IN 47666-9134
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
October 6,2022
Address of authorized person (number and street,city,state,and ZIP code)
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