HomeMy WebLinkAboutMortgage_Begin;� n, STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
: �� FOR DEDUCTION FROM ASSESSED VALUATION
^ State Fwm a3709 (R70/17-08)
-� PrescnGed by Depariment o11.oW Govemment Finance
�INSTRUCTIONS:
To be �led in person or by mail with the CountyAUditor o7 the counry where fhe pmperty is locafed.
Fi/ing Dates: 7) Real PropeRy: Must file dunng [he year lor which fhe deduclion is sought.
2J Mobile /ManNactured Homes not assessed as Real PiopeRy: Must file dunng the tweNe (72) m�thyb9fo�g ��yJ� 37 oleach year
fhe deductian is sought �� � 1 8 U I[
See �everse side /or additional insfructions and qualifications.
AppGCant (owner or conliact buyer- see reSMCtions rn reverse vtle)
Caroi A. Money and Daniel Begin
r
C.�.
Johnson 26-23-16-100-002.181-024/Lot 26 and Lot 27 in Country Ayre Est. #2 """' "";
Assessed vaNe d real poperty as d Mortgage / Cantratt iMebtedneu unpaid as oi Mortgaga / Con:ract i�babtetlness unpaid as of Is iha appGCant Ne sole
Ma¢h 1. artem year March 7. wrtent year =—:-�--_.—_— -0ate of a00��n '-' -" '- - legal ar equitable owneR
5204,800.00 � Yes ❑ No
Ii no, what is Ns / Aer exaU share ot interest? If ovmed wiN someone oNer It�an spouse, inCipte wiUf wliom
If name m recrortl is CiRerem Nan �hat of
Nama of rtqrtgagee w mnVad seDer
Evansville Commerce Bank
CEress of mortgagee or mnvaa se0er (numbe� and sveeL dry. s+ate, and Z/P code)
20 NW Fourth St. Evansville, IN 47708
or other owner or MWer of mortga9e
ot assgnee (number arM slree4 ury, stafe. and ZIP
Is Ne Droperty in Question: Mnm
] Real Pmperty ❑ Mnua',
Mabile
I Does apW��� � O�DertY in any oNer If yes, whac wuntyl Wtut Tasin9 DisUict7 Has Ihis de0uctim been requested m property I
counry in Ind'aru? fw artent yeaYl � NO
n Yes No ❑ Ye5