HomeMy WebLinkAboutMortgage_Obermeierd� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count ow Year
-a�� FOR DEDUCTION FROM ASSESSED VALUATION
�, • SWte Form 43709 (R77 / 609)
�� �l Presrnbed by DepartmeN of Local Govemmen; Pinance
File M
INSTRUCTIONS:
To be filed in person or 6y mail. nn i ed wim:
Filing Dafes: 1) Real Property: Must be completed and dated in fhe calendar year tor which fhe deduction is sought. � Auditor
Mus( 6e filed wi[h the County Audifor or County Recorder oJ the counry where !he property is locafed
on or belore January 5 0! Ihe immediately succeeding calendar year. ❑ n corder
2) Mobile /Manu/acfured Homes nof assessetl as Real Property: Mus7 file wifh fhe CountyAudiroro/fh��BS ITOR
counry where (he property is located dunng the hvelve (12) mon(hs be(ore March 31 0/ each year th
deducfion is sought.
See 2verse side 7or addiGonal inshucfions and qualifiwfions.
�p6wnt (owner w convau buyer - see reSLicfions m reverse vtle)
John A. Obertneier and MisN Obertneier
TaAng Distria Key number / le9al deudDlion
Ft.Branch 26-19-18-101-001.150-026
number
Acsessed value o1 real Oroperry as of Mongage / ConUact i`Mebtedness unpaitl as ol Mortgage / Convact iMebtedness unpaid as o( Is Ue appliwnt Ne sole
7areh 1, curtent year Mamh 1, turzenl year date of applipibn legal or equilaEle awneR
S248,600.00 S213,918.00 0 Yes ❑ No
If no, what is �is I �er e:aa share of interest7
L` name on record is diPerent ihan �hat of a{
Meng Xiong and Geutang Xiong
Name of mortga9ee or wnVaa seller
Fifth Third Mortgage Company
intlicate
Atltlress of rtwrtgagee or conNact seller (number aM s:mef, ciry, stafe, arM ZIP code)
5001 Kingisey Drive, Cincinnali, OH 45227
Name of assignee or other owner or hoMer of rtwrtgage
Address ot assignae (number and sbeet. city. sta.e. antl ZIP catle)
Ooes applicant own pmPerty in any oNer If Yes. whai coun,y?
wunry in InCiana? n Ves ❑ No
vntli swneone aNer than
Taxing Disvict?
whom
Is the property in question: MnuallyASSessed
�❑ Real Property ❑ MnuallyASSessed
Has �his tleEUCtbn been reques:eG on property
for wnent yeaR
❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in Ne amount oC
20 _ 20 20 20 20 _ 20 20
Signature/ojI Counry Audimr Counry Date (monN. day, yeaq
` . ��
I I We certify under the penalry o( per ry that the ve and foregoing infortnation is We and correct and tha� the applicant is a resideN of Indiana and
owner I conVact buyer of ihe aforemen5oned pro rty on date pplication is filetl.
S�naNre n !u� e) �ate (monN, day, yea�
� ' osizoizo>>
F r dent adtlress ot applicant (num0er antl sireef, city, sIale, and ZIP e)
7 Blackfoot Drive, Ft. Branch, IN 47648
Person auUwrized by duty executatl Power ot Attomey or by IC 6-1.142-07 Data (mon0i, day, yeaq
Adaress of authorized person (numberarrd sVeet. crty, state, antl ZIP code)