HomeMy WebLinkAboutMortgage_Hardin (2)dF--�.v, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
:e_. __ FOR DEDUCTION FROM ASSESSED VALUATION
��� S�a:e Fa�m 43709 (R N/ 609) �
'� PreSUiGeC by �epartment of loral Govemment Finance I
INSTRUCTIONS: File Mark
To be Iiled in person or by maiL Porm filed with:
Filing Dates: i) Real PropeAy: Musf 6e comple(ed and dated in the wlendar year for wAich the tleducfion is soughf.
Must be filetl with the CountyAudito� orCounry Recorder oI the county where Ihe property is located ❑ Couniy Audi;or
on or be7ore January 5 0/ the immediately succeeding calendar yeac � �qunty RecoMer
2) Mobile /Manufacfured Homes not assessed as Real Property Musf file wifh the CountyAudito� 07 the
county where Ihe property is located dunng the hvelve (12) monffis 6efore March 37 oleach year fhe
deduction is sought.
See feverse side 7or addilional insfmclions and qualificalions.
Appllram (owner w cmvaa buyer - see resmctions m mverse si0e)
Sue A. Hardin
vg Distria Key num0er / legal Cescnption Recortl num�gr Page numCe2r' ,
nion 26-19-OS-200-000.195-025 / Pt SW NE 83-10 ( � �J:J"f �
AssessM value o� real pmpeM1y as ot Mortgaga / ConUaci indebtedness unpaid as of Mortga9e / Cmtract indebledness unpaid as of Is Ihe appliwm Ne sde
March 1, curtent year Marc� 1, currenl year date ol applicalion legal or equiWble ovmer?
S122,500.00 595,000.00 592,950.00 ❑� Yes ❑ No
I` no. whai fs �is I �er ewd share of interest? If owned wiN someone oNer Nan spouse, indicate wiN wham
I L` name on reoorC is CiPerent t�an fiat of app4cant. indiwte bebw: 15 the property in que56on: Annually ASSessetl
❑� Real Property Q MnuallyASSessed
Mobile Home IC fr1.1-7)
Name ot mongagee or contrect seller
Westem Federal Credii Union
ACtlress o( mortgagee or conUaci 5elier (number arM streef, city, sfate, anC ZIP coCe)
74500 Aviation Blvd, Hawthorne, CA 90250
Name of assi9nee or other owner or holder of rtwrtgage
Address oi asvgnee (numDe� and street. cify, sta.e. antl ZIP cade)
Does appliwnt own pmperty in any other Ii yes, what coun.y? What Taxing Dis�nct9 Has Nis oeductbn bcen wQuas;ed on property
coumy in Indiana? for curtent yeaR
❑ Yes ❑� No ❑ Yes ❑ No
COUNN AUDI70R
Detluc�irn approveA in Ne artaunt ot
20 _ 20 20 _ 20 _ 20 _ 20 20
Signawre of County AuEitor . County �ate (monN, day, year)
I/ We certify under ihe penalty of perjury that the above and foregoing infortnation is lrue an hat t li 's a resident of Indiana and
owner / conVact buyer of the aforemen:ioned property on date application is fletl.
Sgnawre (owne�s lun name) I � ' h, Cay, year)
� 07/07/2010
FuOresidentatlEressolappliwnt(numberarMslreeCaty,stafe,endZlPCOtle) �U� �_^ r�o�o
1144 E 600 S, Ft. Branch, IN 47648 . O L
Person autlarized by tluly execvted Pw.�er ef Attomey or by IC 61.1-12-0.7 Date (monN, Cay, year)
b�:.s.
AdtlressolauNOrizeCperson(numberandsveef,ciry,slate.antlZlPcnde) � I 5�0 ountyRecorder