HomeMy WebLinkAboutMortgage_Englehardt (2)�y"v�.> STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count I Township � Year
,a.,., . S FOR DEDUCTION FROM ASSESSED VALUATION I
�'• ' Stata Fwm a3709 (R10IN-08) Gib . Bran
j Prescnbed by Depanmen� of Local Govemmeni Financa
� INSTRUCT/ONS: File Mark
To be filed in person or by mail wifh fhe CounryAudiror o! tM1e couniy where the property is locared. SEP' % 2� �Z
Filing Dafes: i) Real Pmperty: Must fi/e dunng ihe year for which (he deduction is sought.
2) Mobile /Manulactured Homes nof assessed as Real Property: Mus( �le dunng fhe hvelve (72) monfhs beforEldarch 3�Year
fhe deduc(ion is soughL �- �
See reverse side /or addifional insWcfions and qualifications.
Applican� (owner or conVacf 6uyer - see resmGions an ravarse side)
Jamie Englehardt
Tatirg DiSVict Key number / legal Eesmption Recortl numher Page n� Oer�
Ft. Branch 26-78-24-202-000.495-026/ The E. one half of lot 270 in the LeGrenge p�0� ry
Assessed valua of real property as of Mortgage / Contrau indebteCness unpaid as of Mortgage / Con',raa indebtedness unpaid as ot Is �he appliram Ue sde
Marrh 1, wnent year March 1, wrtent year date of appliwtion legal or equitaWe wmeR
" 578,850.00 ❑X Yes ❑ No
If no. whal is Itis I her exac[ share ot inrerest? If wmeC wiN mmeone other than spouse, inEinte with wtwm
It name on record is AiHerent Nan Nat of appGcant. indiwre bebw: Is ihe property in question: MnuaOy hssesseE
�X Real Property ❑ MnualtyAssessed
Name of mortgag¢C or mntrad seDer
German American Bancorp
AEdre ot mortgagee w wnLatt seller (number arM sbaet, ciry, stata, arM Z/P cpde)
(��,� � 3��� -� � � mc+��r
Name of assignee ar oNer owner or tioker of rtwrtgage
ot assignee (number arW sfreet �+ry. state,
a�
property in any o I( yes, what couny? NTat Taxing Dislrict7 Has Nis deduction been requested on 0 rty
n Yes No for wrtent yeaR
❑ Yes No
COUNTY AUDITOR
Deduction approveE in Ne amount of:
20 20 _ 20 _ 20 20 20 _ 20 _
Sgna;ure of Couniy Autli:w Caunry Da:e (mmN. day. yea�
1/ We certiy under the penalry of perjury that the above antl foregoing intortnation is true and correct and that the applicant is a resident of Indiana and
own r I conUad buyer of lhe aforemenfioned pmperty on dale applicalion is filed.
Sig re(owqeYS fuD ) Date (monN, Eay, yea�
08I23I2072
Fu0 resident aCAress of ap m , streef, ciry, sfafe, and Z!P code)
301 S. Cumbedan L FL Brench, IN 47648
Person auNwizetl by duly executed Power of Attomey or by IC fi-1.1-12-0.7 Date (mmN, day, yea�
AOOress ot auNOf¢eE person (number eM smet. dry. 5lafe. and ZlPCatle)