HomeMy WebLinkAboutMortgage_Sellers .M:,-*A* , STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
�i FOR DEDUCTION FROM ASSESSED VALUATION
R,� i�State Form 43709(R14/1-20) IC'Li tl vC(� Gibson on Otib 2023
a� Prescribed by Department of Local Government Finance
QI��, `,i DEC E R 2022 File Mark
INSTRUCTIONS:To be filed in person or by mail. Y�
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. County Auditor
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)
' Nicholas Sellers
Taxing District Key number/legal description Record^�numberbe (Page number `
026 26-19-18-302-000.682-026/Tretter Park 20,Gibson County �v 9. O� OQ (' J J`
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?
175,750.00 ® 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
® Real Property El Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller FILED
Northpointe Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
3333 Deposit Drive Northeast,Grand Rapids,MI 49546 DEC 0 9 2022
Name of assignee or other owner or holder of mortgage f7,,
Address of assignee(number and street,city,state,and ZIP code) `%/L4e-It4efl &,L
GIBSON COUNTY AUDITOR
Does applicant own propert in a If yes,what county? What Taxing District? Has this deducts n b en requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes o current year? Yes ❑No
A person is not entitled to is 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)tha 's the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Audlor�J^`\W` ""- County `O' 1 Date(mo tt y;r arl
11(nl ) Jand that the applicant i Caf lr�sid�ent`Lof Indiana and
I/We certify under the penalty of perjury that the above and foregoing information is tru�nd correct pP
owner/contract buyer of the aforementioned property on date application is filed.
Date(month,day,year)
Signature(owner's full name)
//J. / A�-' , J December 2,2022
Full/fesidddresf applicant(number and street,city,state,and ZIP code)
703 E Tretter Park Drive Fort Branch, IN 47648 Date(month,day,year)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
December 2,2022
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 FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant of contract seller
f umbla Title
Nicholas Sellers CO F rth t r. : k
5Tnea mount of indebtedn955 F.
Taxing District r'i r'1
Date filed(month,da y ar) 490 4171 ��' e�)
II-CV
- 2 ` Evansvltle,IN
"l 17b79,000 9 2022 026
ryt
Key number/legal description 1, -CI Z L S*,3 1-S
26-19-18-302-000.682-026/Tretter Park 20,Gibson C �7� /� r
, 47/(,,co ou ya.`411� i Date(month,daY.year) +N
Signature of County Auditor/County cord
'`^.�I GIBSON COUNT R
53a1