HomeMy WebLinkAboutMortgage_Mayer (4)�n„I STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
;4_ _ l FOR DEDUCTION FROM ASSESSED VALUATION �-
� State Fwm a3709 (R71 / 6-09)
r Preunbed by Department of Local Cwvemmem Finance
INSTRUC7IONS:
:.� ���- � :.�.'1
i : i ��
1 � � '. I
To 6e filed in person or 6y mail. �^^ � e "'� �
Filing Dates: i) Real Property: Mus( be completed and tlafed in fhe calendar yearlor which fhe tleduction is sought.
Must be filed wilh the County Auditor or County Recorder o/ the munry where the property is located a• itor
on or 6e/ore January 5 07 fhe immediatety succeeding calendar year. Cou R er
2) Mobile / Manulactuied Homes nof assessed as Real Property: Must Re wilh fhe Counry Auditor of [he G'
counry where fhe pmperty is located during fhe tweNe (12) monNS before March 37 of each year the
deduction is sought.
See reverse side Ior addi(ional instrucfions and vualifications.
Appticant (owrrer w wnbact buyer-- sae restrittions m reverse si0e) -
Amanda Mayer
Taring District Key numDer I legal descrip' Record num0er Page numEer
Ft. Branch Township 26-19-19-204-001.2�-026I:Lot 37 Indian Hills Add. (unrecorded) Instruaen
3
Asussed vehie of mal property as of Mortgage / CanVaU indebtednezs�unpaiC as W Mort9age / Con✓aU indebteEness unpaid as ol Is 17ie appGcan e e
Ma�r�h 1. wrtam year March 1, curtent year- --- � -- tlate af appli<ation legal or equitable owneR
591,000.00 ❑� Yes ❑ No
If no, what is his l �er ezact share of interest? If amed wiN wmeone oNer lhan spouse, indicate vnih whom
II name on reco�O is Ci.°.erent Nan Ihat of applirant, intlicate betrr. Is the praperty in quastion: MnuaP/ Assessed
❑� Real ProPeM ❑ AnnuaDy ASSessed
� Mobile Home (IC G7.1-7)
Nama of mortgagee or conVaa seller
Fifth Third Mortgage Company
AtlEress ot mwtgagee w mnVact se�er (number antl sbee4 u�Y. stafe. and ZIP code)
5001 Kingsley Drive, MD: i MOC2P, Cincinnati, OH 45227
Name of assignee or oNer awner or holtler ol mortgage
Address of assignee (numbe� and sbeeC dry, state. an0 ZIP cotle)
Does apDlipnt own property in any olher If yes, what munry? Whai Ta�dng Distrid? Has Nis tleduction been requested on Oroper.y
counry in Indana7 �or cunent yeaf.�
❑ Yes O No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approveE in Ihe amounl ot
20 _ 20 20 _ 20 20 _ 20 20 _
Signa[ure o/ CaunH.4uditor Counry Date (manN, tlay. yea�
I I We certify under the penalry of perjury ihat the above and foregoing infortnation is Wa and wrtect and that the applicant is a resident of Indiana and
owner / canVact buyer of the aforementioned property on date application is (led.
Signature (owners /WI nam Da�q(l+c{'nfMf� v�f2Q 77
Vlil L "L !L
u0 resi ent atldress of pplicanl ( mber and sUeef, ciry, s(ate. arM ZIP cotle)
358 E. 780 S. Comanche Ave.. Ft. Branch, IN 47648
Person aullronzeE Dy duly executed Power of Attwney or by IC 61.1-12-0.7 Da:e (mmN, Oay, yea�
Address ot euNOr¢ed person (number and street. ciry, state. aM ZlPCOde)
...___._ ____________________________"___'__"_'_"'
�