HomeMy WebLinkAboutMortgage_Blankenbergerd/� 4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Townshi Year
�,� ,* FOR DEDUCTION FROM ASSESSED VALUATION
�� _ 2012
� �� State Form 43709 (R71 / 6-09)
-��'-�' Presaibed by Department of Local Government Finance F e c
�m�
INSTRUCTIONS: �
To be filletl in person or by mail. NOV 1°���th:
Filing Dafes: 1) Real Property: Must be completed and dated in fhe calendar year for which the deduction is sought.
Must be filed wifh the County Audifor or County Recorder oI the aounty where fhe property is located � County Auditor
on or before January 5 0! the immediately succeeding calendar year. C��•
2) Mobile /Manu/actured Homes not assessed es Real Property Must (!e with the County Avditor of the County Recorder
counry whe2 the property is located dunng the hveNe (12) months be(o2 March 37 o(each year ��jSON COUNT
deductionissought. . ._ YAV�TB�
ant (Owner or contratt buyer - see
A. Blankenberger
Assessed value of real property as of
March 1, current year
If no, what is his / her exact share of inl
If name on record is diHerent than that �
Name of mortgagee or convact seller
Legence Bank
AEdress of mortgagee or wntract selle.
7325 E. Virginia Street, Evansvill
Name of assignee or other owner or ho
on reverse side)
number/ legal descriplion 26-19-34-400-000.412-024 / Property
10197 S 350 E Haubstadt, Indiana 47639
1934-400.000.412-024
Mortgage / Contract Indebtedness unpaid as of Mortgage I ConVai
March 1, curtent year date of applicaGon
IN 47715
applicant own property In any other
y in Indiana? .1
❑ Yes y� No
ction approvetl in Ne amount of:
20 _ 20 _
yes,
20
someone
/ � � 58Y�
unpaid as of Is the aOPlicant the sole
legaloj equifableowner?
&7 Yes ❑ No
spouse,
he propetly in Question: Annualty ASSe55etl
Real Property ❑ Annualty Assessed
_ . —�
Ia�l�ti�,�Y�er
�-�,����- ` ..................
Card �O.IO`�•i•"•...
20 _ � 20 _ � 20 _
on
20 _
I I We certiry under penalty of perjury that ihe above and foregoing information is We and correct and that the app�irant is a resident of Indiana and
owner I contred buyer of the aforementioned property on date application is filed.
lent addresS4( 7�byliwn� (hum6er and
bY
S 350 E, Haubstadt, IN 47639 �
or
stafe, and
person (numoer ana street, ciry, state,