HomeMy WebLinkAboutMortgage_Dilbeck (2)/"%> STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS � Counry
,s : ,�
(e_. _< FOR DEDUCTION FROM ASSESSED VALUATION �
i� Slale Form 43709 (R11 / 6-09)
�'� Presrnbea by Deparunent of Local Governmen[ Finance (
INSTRUCTIONS:
To 6e filed in person or by mail.
Filing Dates: 7 J Real Property Musf be comple(e0 and tlated in Ihe calendai yea� for which the deduction is soughL �
Mus! be filed wifh fhe Counfy Audifor or Counry Recorder o/the counry whe�e the property is locafed
on or 6elore January 5 o7fhe immediately succeeding calenda� yeac `
2) Mo6ile /Manulacwred Homes not assessed as Real Pmperty Must file with the CounlyAuditor o/ the G
counry where the pmperty is locafed dunng ihe twelve (72) months be(ore March 31 ot each year [he
deduction is sought. �18sON
See reveise side toradditional ins(nicfions and qualifications.
Applicant (ownerwconvac( buyer- see 2stncUOns on mverse sitle)
,�on T. Dilbeck and Jeaneite S. Dilbeck
ortn filed —
C C�i�{�JAudimr
❑ County Recarder
aung District Key number / legal description RecorC number
Montgomery 26-1033-200-003.766.021 Pt El2 NE 33-2-73 I �
Assessed value M real propeny as ot Mortgage / Contract inEe�tedness unpaitl as of Mortgage / Contraa iMebteeness unpaia as ot Is Ihe applicant fie sde
Rtarch 1, wnent year March 1, currenl year Cale of appliplion legal or eQUitaWe rnrner7
5184,800.00 582,000.00 594,200.00 � Yes ❑ No
II no, what is his / her exac� s�are of interest? If ovmed vnth someone oNer Ihan spouse, in�icate Nit� whom
If name on record is tliEerent ihan tha� of applicant, indicate bebw: I5 l'ne propetty in puesfion: Annually Assessed
❑� Real Properry ❑ MnuallyASSessetl
Mobile Hane (IC G1.L�
Name of mon9agee or conVact seller
Herita9e Federal Credit Union
AOtlress oi mortgagee or contract seller (num0er aM s:reet, ciry. sfale,
5388 Old SR 66, Newburgh, IN 47630
Name of assignee or other owner or holder ot mortgage
assi9nae (num0er and snae�. cey. stafe.
Does applicant o-xn pmperty in zny oNer
counry in Intliana7 n
Deduction approvetl in �he amount
20 _ � 20
of Counry Audi;or
yes, x�hat counry? I Wnat Taxing District? I Has thi5 Gi
forwnenl
COUNTY AUDITOR
20 � 20 _ � 20 _
Counly
on praperty
20 20
�ate (month, day, year)
I/ We certify under the penalry of perjury thal the above and foregoing information is lrue and correct and that the applicant is a resident of Indiana and
orxner I conVact buyer of the a(oremenUOned property on date application is filed.
� ,�- % A��--�� U�C�.+�,tl� S
N�iden� adtlress of appliwnt (numberaM sxeet, city, �te, and ZlPcode)
9681 W CR 400 5, Owensville, IN 47665
;rsan aartarized by duty executed Power ol Anomey or by IC 61.Y12-07
ACdress of au'.twrizeC person (number anA s:reet. aty, slate,
(monN,tlay,yea�
12/08/2070
Da:e (rsanlh, Cay, year)