HomeMy WebLinkAboutMortgage_Konrathj a. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count s ear �
a... 4 FOR DEDUCTION FROM ASSESSED VALUATION
S• $tate Fortn G3709 (RN / 6O9) {� q 1
� e Presaibe� by Depanment of Local Govemmen; Finance ° LO I�
INSTRUCTIONS:
To 6e Tletl in pe�son or by mail.
Filing Dates: iJ Real Property: Musf 6e completed and dated in (he calendai yea� for which !he deducfion is sought.
Musf be filed with fhe County Audifor or Counry Recorder o(1he counry where the pmperty is loca(ed
on or 6e/ore January 5 o7fhe immediafely succeeding calendar year.
2) Mo6ile / Manulaclured Homes not assessed as Real Property: ldust file wifh the CounryAuditor of fhe
covnty where the property is locafed dunng the twelve (72J mon[hs 6efo�e March 37 0l each year t6e
deduction is soughf.
See reverse sidelor addilional instruclions and quali�cations..
File Mar
�
Fonn �AeA wiU
�isSONO upa�,�aclA?fQR
County Recorder
ic�3f110�� w ca+'vaci buyer - see msfnctiwrs on ieverse slde)
1 µu.at
-M+ehaeMJ. Konraih and Kaci M. Konraih
Tazirg Dis;ntl Key numCeN legal tlescnption Record number Page number
Fort Branch 26-19-79-701-000.848-026 Lot 21 East View Addition 11
AssesseA rdWe d real prope ,ry as of MoM1gage I ConVaa inEebteEness unpaiC as ol hlortgage / ConVact intleGtetlness unpaid as ot Is me ava���� �e sde
vdi 1, wrtent year Marc� 7, cunen� year dare of aDP����� legal or equitaMe owner?
0,100.00 S57,468.84 ❑� Yes ❑ No
If no, what is his / her exact share of interest9 If owned vnN someone olher l�an spouse, inEicate with whom
I( name on recorG is EiFerent ihan that of applicant, iMicate Cebw. . Is the property i^ question: Mnuallylusessed
❑� Real Property ❑ MnuallyAuessed
Gregory A. Burger and Donna K. Burger Moale Home pC s-t.ia)
Name ol mortgagee or wnVact seller
The Bank of Henderson
Adtlress of mortgagee or contract seller (number antl s;reet, ary, safe, antl ZIP tode)
208 N. Main Street, Henderson, KY 42420
Name of assignee or other owner or hoMer at rtwrtgage
Adtlress ol assignee (number antl sbeet. city. state. and LP code)
Does aPplicam wm pmperry in any oUer Ii yes, what coun.y? �Ynat Tazing Disina7 Has Nis deGUCtion been requesteC on propeM1y
counry m Intliana? � Yes �❑ No (or curtenl yeaR � Yes ❑ No
COUNNAUDITOR
Oeauclion apPrwea in fhe artwum ot
20 _ ZO _ 20 _ 20 20 _ 20 20
Sgnature ol Counry AuEi:or . Counry �ate (momh. tlay, year)
I I We cerUfy under the penalry of perjury that the above and foregoing informaUOn is We and wrtect and that the applicant is a resident o( Indiana and
owner I wnvact buyer of the aforementioned prope .ry on date application is filed.
i9natu e wnels fW name) Date (rtanN, tlay, yea�
, . `� osioano„
Full resident ad ress ot appliont (number arW srreet, ciry, stafe, and ZIP cade)
304 S. Willard SVeet, Fort Branch, IN 47648
Person authorizad by duly executed Powar o/AROmey ar by IC 6-1.1-12-0] Date (rtronN, day, year)
Atloresso/aullwrizeCperson (numberarrd5veel.city,slafe.andZlPCOde)