HomeMy WebLinkAboutMortgage_Burger,,.�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS �
ai� � FOR DEDUCTION FROM ASSESSED VALUATION
�3� •`�. �;` State Form 43709 (R71 16-09)
Presaibed by Department of Local Government Finance
�
INSTRUCTIONS:
To be filled in person or by mail.
Filin9 Dates: i) Real Property: Must be oompfeted and dated in lhe calendar year7or which the deduction is sought.
Must be �led with the Counry Auditor or County Recortier o/ lhe county where Ihe property is located
on or before January 5 of Ihe immediatety succeeding calendar yea�.
2J Mo6ile /Manufactured Homes nol assessed as Real Property: Must �!e with the County Audifor o7 the
crounty where lhe propeRy is located dunng the twelve (12J monfhs be(ore March 31 0l each year the
deduction is sought.
pputant (owner or con;rac! Duyer - see resmcnons on reverse sioe)
errence D. ur r and Mahala A. ur er
axing District Key number / legal description 26-17-02-400-004.437-021 / PropErty
� Address
Grn� 7815 W 500 . S Owensville, Indiana 47665
PIN
_ � zm�nn_nne dz�m �
ssessetl value of reai property as
larch 1, curtent year
no. whal is his / her exact share ol
name on rewrd is diHerent than It
March 7, cunent year
S 171,000.00
of applicant. indiwte below:
Name of mortgagee or contract seller
Heritage Federal Credit Union
Adtlress of mortgagee or contract seller (�
5388 Old State Highway 66, Newbu
Name of assignee or other owner or holder
20
IlCdnt oW n
Indiana?
i. IN rva�q_
mortg
nd sf�eeC ciry, stare �� �� V
Dra'�v'e1'!\`O��o?- `SlQ�
any other • . , ,
S1
P
Township Year
`z��a
��� � Cal��g Auditor
C � �. M,,,�ieuniy Recorder
QIBSON COUNTy
�� � � �
as of Mortgage / Contract indebtedness unpaid as of Is lhe applicam the sole
date of application legal quitable owner?
t,�Yes ❑ No
med with someone other than spou5e, indicate with whom
I the property in question: Mnualty Assessed
Real Property ❑ Annuaily Assessed
approved in Ihe amount of:
�
CaI'C� l�i�. ..
20 20 _ 20 _
wrreN year?
2�
on property
Yes ❑ No
20
I I We certify under penalty of perjury that the above and foregoing information is lrue and correci and ihat ihe applicant is a resident of Indiana and
owner I wntrect buyer of ihe aforemeniioned propeAy on date application is filed.
r...
75 W 500 . S, Owensville, IN 47665
or
person
(mon;h, tlay, yea�
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yea�