HomeMy WebLinkAboutMortgage_Callahan (2)d,.=.�o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS u n ip � Year
.a._,_ 9 FOR DEDUCTION FROM ASSESSED VALUATION
�'� '� State Form s3709 (R71 / bO9) 5�
� Presaibed by Department d Local Govemmem Finance
INSTRUCTlONS: JAN O Z�� Mafk
To 6e filed in person or 6y mail. Fwm fled wim:
Filing Dates: 1) Real Property: Must be complefed and dafed in the calendar yearlor which fhe deducfion is so
Must 6e filed wi(h (he Counry Audiror or Counry Recorder ol the county where the property is I � Counry Auditor
on or before January 5 o/ fhe immadiately succeeding calendar yeac Q�pp(]y C(]V �T,(�ty Recorder
2) Mobile /Manulaciured Homes nof assessed as Real Property: Musf �le wifh fhe Coun(�l{LafSr allfiS
counry whe2 the property is locafed tlunng !he tweNe (12) months be/ore March 31 oi each year the
deduction is sought.
See reverse side for addilional insfrucfions and qualifications.
Aoo6cant (owrrer w tontraa bwer- sae resvicfions m reverse siCe1
Sean P. 8 Rebecca S. Callahan
Taring District Key numbeU legal Cesviption
Francisco Township 2613-79-202-000.750-005
Assessed vaNe d real prope ,ry az oi Mwcgage / Contraa iME
March t, �vrtent year March 1, wrtent year _
no,
name on
Name ot mortgagae w wnvan se0er
Fifth Third Mortgage Company
AEtlress of mortgagee w wnNact seller (number antl sfreef, ciry. sfa:e. antl ZI
5001 Kings�ey Drive, MD: 1MOC2P, Cincinnatti, OH 45227
o»nerornoWerofrtartgage
ier anC sfreeG aty, state. antl ZIP crotle)
Dces applicant ovm properry in any other
counry in Inaiana?
❑ Yes
No
It yes. w�at counry?
the
WhatTazing OisVict7
t indeb:edness unpaid as ot Is Ihe appliwnt CfE50T8"'�'"-' �
_ _ ' ' -"- legal or equitaWe owneR ' -
❑� Yes ❑ No
ie property in question: MnualtyASSesseG
Real Property ❑ MnualyAssessed
Mobile Home IIC 61.
: inis detluction baen requestetl on pmperty
curtent yeaR � �
LOUNTY AUDITOR
Deduclion approveC in Ne artwunt o[
20 _ 20 20 20 _ 20 _ 20 20
Syna:ure of CounryAWi:or Counry Da:e (mon:h, day, yea�
I/ We certify under the penalty ot perjury that the above and foregoing infortnation is We and cortect and thai the applicant is a resident o( Indiana and
owner / wnVaU buyer of the aforementioned property on date application is filed.
Sg mr o �u am Date ( ion�Jth, ay, /yea )'] �
i+1� ` l GCJ �
Fu0 resident adEress of appiicant (number arM slreet. pry, 5tate, end ZIP cotle)
206 W. Main, Frandsco, IN 47649
Person auNwizaG Oy Euly executeG Power of Attomey or by IC bt.f-12-07 Date (rtwnN, tlay. yea�
Address of auNOraed person (numbar and sveet. ciry, sta(e, entl ZlP cotle)
J