HomeMy WebLinkAboutMortgage_Hallam•.�..��a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship I Year
,�._ _ l POR DEDUCTION FROM ASSESSED VALUATION
� State Fwm 43709 (RN / 6-09)
°� - � Prewibed Dy DeDartment of local Govemment Finance
i a
INSTRUCTIONS:
To be filed in person or by mail. ile w�:
Filinq Dates: 7J Real Property: Must be completed and dafed in fhe calendar yearlor which fhe deduction is sought.
Mus16e filed with the CountyAuditor or County Recofder o7fhe county where fhe pmperty is located ❑ Counry Auditor
on or belore January 5 o/fAe immediafely succeeding calendar yeac y�bef
2J Mo6ile / Manulacfuied Homes nof assessed as Real Properfy: Must file with the County Audifoi o/ fhe r�
counry where the property is located dunng the nvelve (12J months 6e�ore March 37 of each yea� tAe
deeuction is sought GIBSON B6UNTV AUBIfiBfi
See raverse side !or additional instnictions and qualificafions.
AppGCant (owner a convad buyer - see reshictions m reverse side)
�ANTHONY D. HALLAM AND DANA J. HALLAM
:axi'gDistrzt Keynumber/legaldestnplinn Recordnumber Paganumber
JOHNSON 2623-16-100-002.06-024 o�OI �
Assessed rehie d mal p'operty as oi Mortgage / Contract indebtedness unpaid as W Mortgage / Con',raG iMebtednass �npaid as of Is the applirani Na sde
Mart�h 1, artem year March i, wrten� year data of appGcation legal w equiable owneR
304,500 279,900 285,500 ❑� Yes ❑ No
It no. what is his l �er ezaIX share of interest? tl ownetl with someone oNer Uun spousa, inEicate with wl�an
If name on record is d.F.erent Nan �hai of appticant, intlicate bebw. Is Ne pmperty in quasiion: MnuaOy Assessetl
❑� Real ProPeM ❑ MnualyASSessed
Mobile Home QC 61.1-7)
Name oi mortgagea ar conVaa se0er
HERITAGE FEDERAL CREDIT UNION
Addrass of mortgagea or mnVact uAer (number arM sUeet, citg sta:e, aM ZlP cotle)
5388 OLD STATE RD 66 NEWBURGH IN 47629
Name of assignee or oNer owner or Iwltler of rtwrtgage
Address of assi9nee (num0er antl slreet. dry, sfate, arM ZIP code)
Does appGnm am property in any oNer If yas. what counry7 What Taxing DistriIX7 Has Nis Eeductim been requesteC on property
counry in IMiana? �or cunent yeaR
❑ Yes ❑ No ❑ Yes ❑ No
COUNTY AUDITOR
Deduclion apprweC in Ne amount of:
20 _ 20 20 _ 20 _ 20 _ 20 _ 20 _
Sgnacure of Counry AuOitor Counry Date (rtronfh, day. yea�
� I/ We certify under ihe penalry of perjury that the above and foregoing information is We antl cortect and Nat the appliwnt is a resident of Indiana and
owner / conVad buyer of the aforementioned property on dale application is filed.
�gn .0 '(o e/s tWl name) t Data (monN, tlay, yea�
.. �. i q ,vzzno,o
Pu0 resWent aGd255 plicant (nu a tl sflaef. city, sfate. and ZIP code)
1843 E SIERRA DR HAUBSTADT IN 47639
Person auUwrized by duly exewteE Paxer of Attomey or by IL 61.142-0.7 Data (monfh. dag yea�
Atltlress of auihorized person (number arM stmet, city, state, antl ZIP cotle)