HomeMy WebLinkAboutMortgage_House.�• �'�o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
a� ^ i FOR DEDUCTION FROM ASSESSED VALUATION
.4._,_
� State Fwm s3709 (Ril / 6-09)
�",,;; � Prescnbe0 by DeDartment of Local Govemment Finance
File Mark
INSTRUCTIONS:
To be filad in person or 6y mail.
Filing Da[es: 7) Real Property: Must be completed and dated in fha calendar yearlor which (he deduction is sought.
Mus16e filed with the County Audifor o� County Recorder of the counry where the property is located .'�, n Auditor
on or 6e/ore January 5 o7fhe immediately succeeding calentlaryeac ❑ u Recorder
2) Mobrle / Manufactured Homes nof assessed as Real Ploperty: Musf file with the County Audita ol the
crounry where the property is lowfed dunng the fweNe (12J monfhs before March 37 0( each year Lie�BSO TOR
tledaction is soughf.
See reverse side lor additional insiructions and quali(cations.
AppGCant (owner w conlract buyer- see ms4ictions m raverse side)
Christian R. 8 Elizabeth M. House
Taving Disvia Key number / legal descripGm Recortl number Page number
Center Township 2G12-24-400-001.550.004 / Pt SE 24-2-10 �� �� �
PssesseC value d real property as of Mortgage / ConcaU iMebtedness unpaitl as of Mongage / CanVaG inEeGteOness unpaiE as of Is Ihe appliwnt Ne sda
Mart�h 1, wrtent year Marcl� 1, cunent year date of appliwtion legal or equitable owneR
5201,286.00 ❑� Yes ❑ No
If no, what is his / her ezact share of interest? I( wmeC wiN mmeona other Nan spovse, inEinte wiN wl�om
If name on recorC is di3erent Nan Nat of appticant, intliwte bebw. Is Ne pmperty in quesibn: MnuaOy Assessed
�❑ Real Property ❑ MnuaDyASSessed
Mobile Home (IC 6-1.1-7)
Name of rtartgagee w wnVad se�er
Old National Bank
ACEress of rtrortgagee w mntrad seller (num0er and sfreef, cdR sfafe, ard ZlPCOde)
1 Main Street, Evansville, IN 47708
Name of assgnee or oNer owner or Iwker of rrortgage
ACCress of assignee (number and st2eG dry. stare, anC ZIP code)
Does appliwnt am property in any other tl yes, what wunryl Whai Taring DisVia7 Has Nis deductlon been requested on property
coun m InCiana? 1or curtem eaY!
ry ❑ Yes ❑� No Y ❑ Yes ❑ No
COUNTY AUDITOR
Detluction approved in �he amounl oi:
zo _ � zo � 20 _ � zo _ � zo _ � zo _ � zo
Signature af Counry Audi:or
I/ We cerUfy under ihe penalry of perjury that the above and foregoing informalion is We and cortect and Nat Ihe applicant is a resident of Indiana and
mvner / conVad buyer of the aforementioned property on date applicatlon is filed.
�nypyelownefs lull name). ., Dat@ (mqnN, tlag yea�
2229 S. 550 E., Frandsco, IN 47649
auNonzeG Oy duty executed Power of Attomay or by IC 61.142-0J
Adtlress of auNOr¢eE person (numheranU 5neef, uty. state,
Date (monN, Eay, yeaQ