HomeMy WebLinkAboutMortgage_PfeildF•�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
�e._ ,: FOR DEDUCTION FROM ASSESSED VALUATION
�� � Slate Fortn a3709 (RN 16-09)
�' Prestnbea by Dapanment of Local Govemment Finance
INSTRUCTIONS:
To be filed in person or by mail.
Fifing Dates: 1J Real P�operty: Must be complefed and dated in lhe wlendar year (or which the deduction is sought.
AAUSf be filed with fhe CountyAUdifor or Counry Recorder o/ the counry where (he pioperty is /ocafed
on or 6e/ore January 5 o7fhe immediately succeeding calendar yeai.
2) Mobile / Manu7actured Homes nof assessed as Real Pmperty Must fi/e with 1he CountyAuditor of fhe
counry where (he property is located dunng the twelve (72) months be/ore March 37 ot each yearthe
deducrion is sou9ht.
See �everse side lor adtlitional inshuctions and qualifiwtions. GIE
Aoolicant lowner w cmvacf bwer - see resUictirns rn reverse sidel
T
N �g�1tyAudiror
Caunry Rewrder
M. Stan Pfeil and Erin M. Pfeil
artng Olstricl Key number / legal descnption RecorE numbe� Page numEer
White River 26-0436-200-001.649-027 Lot 1 Hoosier Homestead Sub p��//— -�/
ssessed value M real pmperty as of Mortgage / ConVact inCebtedness unpaid as of Martgage / ContraU iMebtetlness unpaid as of Is Ne appliwnt Ne sde
larcl� 1, artentyear March 1, wrrent year date ol applicaGOn legal or eQUitaWe awneR
�5243,000.00 5230,000.00 S232,000.00 ❑� Yes ❑ No
no, what is Ns / her enact snare ot interest? If ownetl wiin someone oiher Nan spouse, indicate with whom
If name on reoor0 is diPerent than that of applicant'vWicate Oelow:
Name o( mongagee or wnVact seller
German American Bankcorp
Address of mortga9ee or contract seller (number arM sfreet, pry, sfate, antl
PO Box 360, Jasper, IN 47547
Nama of assignee or other ovmer or holder of imrtgage
Address of asvgnee (numDer and veeL tify, sfa:e. and ZIP code)
Does app�iwnt own pmperry in any oNer II yes, what caun;y'
county in Indiana?
❑ Yes ❑� No
Deduction aoorovetl in ihe amwnt oY.
20 _ � 20 _ � 20 _
I I We certi(y under thE penalty of pe�Gry ihal lhe
owner / wnVact buyer of Ihe atorementioned pm�
NTat Taxing DisVict?
COUNTYAUDITOR
20 20 _
Cowry
Is the property in puesUm: MnuallyAssessed
❑� Real Properry ❑ MnuallyASSessed
Has this deduction been reques;ed on property
tor cuerem yea/t
❑ Yes ❑ I
20 20
Oate (monfh, Cag year)
nd foreg�q information is We and corteci and that the applicant is a resident of Indiana and
date application is filed.
'/ \
Fu resid t ddress of p icant ( umber aM sVeef. ary, sfa e, and Zl ca
2343 N. Tower Lane, Pnnceton. IN 47670
Person autMrized Cy dWy executed Power of Anomey or by IG 61.142-07
person (numberandsVeet.crty.state.antlZlPCOde)
Date (rzanN. day, yea�
12/27I2010
Dare