HomeMy WebLinkAboutMortgage_Huot��.at STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
= FOR DEDUCTION FROM ASSESSED VALUATION
� ` State Fortn 43709 (Rt1 /6-09) i on bia 2012
�0�;, Presrnbed 6y Department of Local Govemment Finance
ark
Ir•crRUCTIONS:
� filed in person or by mail. N � V 9 ' e'�n flied witn:
hu,ug Dates: 1J Real Property: Must be complefed and dated in the calendar year /or which the deducfion is sought. � County Auditor
Must 6e (led with the CountyAuditor or County Recorcfer o/ the county where the property is I�ca�
on or before January 5 0/ fhe immediately succeeding calendar yeac County Rewrder
2J Mobile /Manufactured Homes nof assessed as Real P�operty: Musf file with the CountyAuditor o/ the
county where the property is located during Ihe hvelve (12J months before March 31 of�$�9�JNTY AUDITOR
deduction is sought.
See reveise side lor additional instructions and qualrfications.
.4P�tdn� (Owne! w COnV3ct Dlryer- see resfiicbOnS On /EV¢i5C Side)
RobertJ.+louL � � -
Tawng District Key number / legal tlescripuon Record numCer Pa e num�er
Gibson 26-13-24-400-000.884-006 Pt. SE 24-2-9 p�Q �' �y3
Assessed value o1 real properry as of Mongage / Contraci indebtedness unpaitl as ol Mortgage / Cmtract indebledness unpaiE as of Is the applicant the sole
Mard� 7, anent year March 1, wrtent year date of application legal or equitaMe owner?
51700.00 108500.00 113386.00 ❑� Yes ❑ No
Mat is his / her exac[ share of interest? If owned with someone other Ihan spouse, iMiwte vnU whom
If name on recorE is tliRereni Ihan that of apqipnt, indicate belmr. Is the property in ques;ion: Mnualty 0.ssessea
❑� Real Property ❑ Mnualy Assessed
Mobile Home (IC 61.1-7)
Name of mongagee or contract seller
Hallmark Home Mortgage, LLC
Address of mortqaqee or conVad seller (numberand sveef, ciry, siate, and ZIP code)
7821 Coldwater Road, Ft. Wayne, IN 46825
Name of assignee or oNer owner or holder of rtangage
Address of assignee (number and stree; dry, sfate, aM ZIP crode)
pp6cant own property in any other If yes, whai count� What Tadng Distnct? Has ihis Oeduction been requesteE on properry
� in InEiana? fw arrent yeaR
❑ Yes ❑� No ❑� Yes ❑ No �
COUNTY AUDITOR
Detluaion approvetl in ihe amount oC
20 _ 20 20 _ 20 _ 20 20 _ 20
Signamre ot Counry Auditor Counry Da;e (monM, day, yea�
1 I We certify under the penalty of perjury that the above and foregoing infortnation is We and correU and that the applicant is a resident of Indiana and
owner / wnvacl buyer of the aforementioned property on date application is filed.
�' ^aWr o neYS u0name) �� Date (monN, day, yea�
10128/2011
�Ful resident adOres of pplicant (num6e� and sheef. dry, state, and ZIP code)
11387 County Road 200 SE, Oakland City, IN 47660 �
Person authorized by duty executetl Power ol Anomey or by IC 67 J-72-0J Date (month, day, yea�
Addressolauthwizedperson (numberandstreef,cey,uafe,andZlPCOdej