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Mortgage_Tuckerea. ^�o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year ~ � FOR DEDUCTION FROM ASSESSED VALUATION �, � State Form 43709 (R71 / 6-09) ���' � Prescribed by Department ol LoW Govemment Finance ��� File Mark INSTRUCTIONS: To be filed in person or 6y mail. Fw^+ � Filing Dates: 1) Real Pmperty: Must 6e completed and dated in the ralendar yeaNOr which the detluction is s g t. Mus1 be filed with the County Auditor or Counry Recnrder ol the counry where the pmpeRy is located . Co ry itor on or be7ore January 5 0! the immediately succeeding calendar year. County Recorder 2) Mobile / Manufactured Homes not assessed as Real Property: Musf file wi(h (he County Auditor o! the county wM1ere tAe propeRy is locafed dunng the M1veNe (72) months 6efore March 37 of each year the U� � tleduction is sought. See reverse sde !or additional instruclions and qualifications. AppGCant (owner cv tontrdtf Duyer - see reSMClions on reverse SiCe) ~/G� rG% � BRYAN D. TUCKER AND VELVET D. TUCKER i nu axing Distrid Key number/ legal dascription Record number � Page nurt7per � JOHNSON 26-1&35700-002.714-024 5� 0.csessed vaNe d real qoperty as of Mwtgage I ConvaU i�Webtedness unpaid as of Mortgage / Con•,2U indebtedness unpaid as of Is �he applicant �he sde March 1, ament year Mara� 1, wrtent year tlate ot appGration legal or equkable owner? 256,100 187,000 788.000 0 Yes ❑ No If no. what is his / her ezac� share of inlerest? If owneC wiN someane other ihan spouu, inCicate wiN whan If name on record is Cifterent Nan that of apd���L �ndicate bebw: Is tha pmperty in question: MnuaOyASSessad � Real Property ❑ MnuaOy Assessed Mobile Home (IC 61.1-7) Name oi rtartgagae w mntract se0er HERITAGE FEDERAL CREDIT UNION Address of rtartgagee w contracl se0er (number eM strae4 cily. s+ate, aM ZIP code) 5388 OLD STATE RD 66 NEWBURGH IN 47629 Name ol assignee or oNer owner or hd0er ot rnort9age Mtlress of assignee (numberand snaeS ciry. stale. antl ZIP cotle) Does applicant own property In any oUer If yes, what munry9 What Tawng DistnU7 Has fhis deEuction been repuesteE on properry counry in UWiaria? for cvrtent yeaR ❑ Yes ❑ No ❑ Yes ❑ No COUNTYAUDROR DeEUCtion approved in Ihe amount of: 20 20 20 20 20 20 20 Sgnamre ot CounryAUtliror Caunry Date (rtwnfh. day, yea� � I/ We certify under the penatty of perjury that Ne above and toregoing informatlon is we and correct and Nat the applicant is a resident of Indiana and owner / wnVact buyer of tha aforementioned property on date application is filed. Signatur (ownels fWl name) � J Date (rtiOnlh, tlay, yean t I�..�•�-- %� � N �t , tvian0io FW resiEen dress of appliwnt (numbararnl sfree( tiry, stare, aiM ZIPwEe) 9807 S JOY LANE HAUBSTADT IN 47639 Person auNorizeO by tivy ezewtetl Poxer of Anomey or by IC G1.142-0J Data (monlh, day. yea� Address ot auNOr¢ed person (number ami sveet, ciry, s�afa, and ZIP code)