HomeMy WebLinkAboutMortgage_Hartkea�2,. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count 7ownship Year
� FOR DEDUCTION FROM ASSESSED VALUATION
StareF«ma37o9(R�t/6-09) Gibson Haubstadt 2011
•�� f Presaibed by Department of Lacal Govemment Finance
File Mark
INSTRUCTIONS:
To be �led in person or by mail. Fortn fJea with:
Filing Dates: 7J Real Pioperty: Must be completed and dated in the calendai year for which fhe deduction is sought.
Must be filed vnth the CounryAUditor or Counry Recorder o7the counry where the property is located ❑ Counry Auditor
on or bePore January 5 o7fhe immediafety succeeding calendar yeac ❑ County Recorder
2J Mobife /Manufactured Homes not assessed as Real Property: Must file wi(h fhe CountyAUditor o/the
counry wheie the property is /ocated dunng the rtveNe (72) months 6efore March 31 of each year the
deductlon is sought. .
See reverse side /or additional inslruc[ions and qualifica6ons.
npqicant (owne� or convact Duyer - see resvictions on reverse sirle)
Ronira D. Hartke
Tarirg District Key number! legal descnption RecorO number Page number
Gibson 261931303-000.392-009 O' a
Pssessed vaNe of real propery as of Martgage / Contrad indebteEness unpaid as ol Mortgage / Cantracl intlebtetlness unpaiC as ol Is Ne applimnt ihe sole
March 1, anmt year Martl� 1, cunent year date of application legal ar equitable owner?
119,000.00 106,000.00 738,370.00 0 ves ❑ No
rro, what is his / her exact share of interestt If owneE with someone aher ihan spouse, indicate wiN vRiwn
If name on recor0 is d',He2nl than Nal ol applicant, indicate bebw: Is ihe property in questlon: Mnually Assessed
�❑ Real Property ❑ Mnuallyl�ssessed
' Mobile Home IC 61.1-7
Name of mort9agee or conVacl se9er
Top Flite Financial, Inc.
Address of rtrortgagee or oon4aa se0er (num6er and sLee( ury, sfate. and Z/Pmde)
123 E. Grand River Ave., Williamston, MI 48895
Name of assignee or oNer ovmer or hdCer ot mongage
AtlCress of asslgnee (number arrd sfreet, city, s(afe, and ZlPCOde)
Does appliwnt ovm property in any oNer If yes, what munry? W�ai Taring Disinct7 Has ihis deduUion been requesled on pmperty
counry in InEiana? for wvent year?
❑ Yes �❑ No ❑O Yes ❑ No
COUNTY AUDITOR
Deduction approved in Ne artrount of:
20_ 20_ 20 20_ 20_ 20_ 20
Signature of CounryAUOitw Counry � Date (manN, day, year)
I I We certify under ihe penalry of perjury that the above and foreqoing informatlon is We and wrtect and that Ihe applicant is a resident of Indiana and
ovmer / conVact buyer of the aforemenlioned property on date applicaUon is fiied.
igriature ( e u me � Date (month, day, yeaq
8126/2011
f W resident address of appliwnt nu a t, crty, slate, and ZIP code)
314 S. Race Sveet, Haubstadt, IN 639
Persan auGwnzed by Euty exewtetl Power of Atinmey or by IC 61.742-0.7 Date (monfi, day, year)
Address of authorized person (number antl street. ciry, stafe, arM Z/P code)
y