HomeMy WebLinkAboutMortgage_Walker (4)d��, � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
e._ = FOR DEDUCTION FROM ASSESSED VALUATION
3, State Fwm <3709 (R71 / 6-09)
°�� ( PrescriEed by Depanment of Loral Govemmen: Finance
INSTRUCTlONS:
To be �led in person or 6y mail.
Filing Da(es: i) Real Property: Musf be complefed and dated in [he calendar year for which fhe deduciion is soughf.
Must be filed wi(h fhe CountyAuditor or Counry Recorder o/ the counry where fhe property is locafed
on or 6elore January 5 0l the immedialety succeeding calendar year.
2) Mobile / Manulacfured Homes nof assessed as Real Property: Must file wi(h the CounlyAuditor o! fhe
counry where fhe property is located dunng the fwelve (72) months be/ore March 37 o7each year the
dedvction is sought ,
See reve�se sidelor additional instmctions and qualilications. GIE
Appliwnt (owner or con;rad buyer - tee msMClions on reverse siCe)
Shawn Michelle Walker
Tadng DisVia Key number I legal tlescriplion
Haubstadt 26-18-36�03-000-349-009 Lot 804 3rd Addtn of West Heights — (
6 C[�q�y�y�y Auditor
Counly Recorder
Page number
ssessed value ot real prooe .ry as of Mwtgage / ConNact i�MeEledness unpaid as ot Mort9a9e / ConVaa iMebtetlness unpaid as of Is Ne applicanl �he sde
�ryi 7, qm¢nt ypy March 1, cunent year date of appli�atbn le9al or equitaWe owner7
!i735,000.00 5178,262.00 0 Yes ❑ No
no. wha� is his / her eract share of interest? -. It owned with someone oUer Nan spouse, intlicate v.it� whom
If name on recor0 is diRerem Nan Ihat of applica^t. indicate Gebw.
Kenton L. Mayer and Lucinda K. Mayer �.��}- Q(�,��
Name of mortgagee or conUact seller �- --"� �'�' `
Fifth Third Mortgage Company
AdEress al mortgagee or contract seller (number aritl: D I 1��' C� I� I�� �..�O � I
5001 Kingsley Drive, Cincinnati, OH 452: � � � � � � � """
Name of assignee or other ovmer or �oWer at rtwrtga� 2'S (� � '
Card \'O. .. �»t ��L�
AOEress
Does 2
counry
ntl str9ef. ary. sfa:e. a
any oNer If yes, MTat counry?
Yes n No
NTat Tadng Disv¢�r
Is the property in question: Annualty AssesseC
❑� Real Property ❑ MnuallyAssessed
Has this deEUCtion Ceen reques,ed on property
(orwrtenlve2R .--. .-.
COUNN AUDITOR
Oetluclion approved in Ne amount o/:
20 _ 20 _ 20 _ 20 20 _ 20 _ 20
Signawre ol CounryAUEi;or Covnry Date (rtronN, day, yea�
I I We certify under the penalty of perjury Ihat lhe above and foregoing infortna6on is We and cortect and lhat the applicani is a resident of Indiana and
owner I conVact buyer of the aforemenGOnetl property on date application is filed.
-gna� r(owners Iv0 e Daro (ma+0, day. yea�
O6I30/2071
u0 resident address of appliwm (nu er eM street. ury, state, end ZIP co0e)
717 S. Damosa Drive, Haubsiadt, IN 47639
Person auUwrizetl by duty esewle0 Pov.•er ot Attomey or by IC 61.142-0A Date (monUr. day, yea�
Atltlress of authorized person (number arM SVeeL ciry, siare. and ZIP code)