HomeMy WebLinkAboutMortgage_Brewer --- STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
F .:..%, FOR DEDUCTION FROM ASSESSED VALUATION
RECEIVED
;,��-.,:.,,,`,��p State Form 43709(R14/1-20) Gibson 2022
Prescribed by Department of Local Government Finance NOV2 2022
^ b \ File Mark
INSTRUCTIONS: To be filed in person or by mail. 1`Jp�yX�� e? o filed with:
Filing Date: Form must be completed and dated in the calenpajr year for which the deduction is sought. County Auditor
Must be filed or postmarked with the County Au itor or County Recorder of the county where the propert
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)
Justin Brewer
Keynumber/legal description Record number Page num
Taxing District Q 2 Z
JobeS 00q Z
26-19-31-301-000.048-009/Pt SW 31-3-10(.208 A) .
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the o applicant
pl caantthe sole
assessment date,current year assessment date,current year date of application leg equitable
er?
If .00
$112,500.00 JY�J Yes El No
n1 If no,,what 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:
I t Real property Propert in question:y Annuallynnuelly Assessed
Ase ed
F �' ❑ ss
M
Mobile Homee ss 6-1.1-7)
Name of mortgagee or contract seller
United Wholesale Mortgage, LLC ISAOA/ATIMA ) NOV 1 1 2022
Address of mortgagee or contract seller(number and street,city,state,and ZIP code
P.O. Box 202028,Florence,SC 29502-2028
Name of assignee or other owner or holder of mortgage !/ /L�,y� �7
sc%lsaj /2 .. ;v/f•'74 )
Address of assignee(number and street,city,state,and ZIP code) GIBSON COUNTY AUDITOr
Does applicant own property in any If yes,what county? What Taxing District? Has this deductio b en requested If yes,state amount of deduction
on property for r�Yes ❑ NO
in Indd iana?
othercounty ❑Yes ❑ NO current year? C
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or onl�'
t 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 20 20 20 20
Signature of County Auditor
_ County Dat (m th,day,year)
0\ r).S Gibson 1( (C' a°
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant is a sir nt of Indiana and
owner/contract buyer of the aforementioned property on date application is filed. I Date^q�,day,mar)z�
gnawn i name) `l/l/ q �J
(x� !AA
Full re dent address of applicant(number and street,city,state,and ZIP code)
107 ast Gibson Street, Haubstadt, IN 47639 Date(month,day,year)
Person 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$1O,000-
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Order No. Name of mortgagee or contract seller
Justin Brewer 122-2038 I United Wholesale Mortgage, LLC ISAOA/ATIMA
Amount of indeb Taxing District
Date filed(month,day,year) t Fes-) FT-�� I Regional Title Sere:
0.\O 202 Z I A oust of 0.00 1 ■ J
Key number/legal description L L.—
26-19-31-301-000.048-009/Pt SW 31-3-10/ 208 A) NOV ��t�022 Date(month,da ,year) o
Signature of County Auditor/Cty Recor er � I \\• '� C .._
Gibson
iy ( a. J/lr n i o rfi
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GIBSON COUNTY AUDITOF. ^' 0