HomeMy WebLinkAboutMortgage_Helmer (2).R "'�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
°i_ � FOR DEDUCTION FROM ASSESSED VALUATION
�� � � State Form 43709 (R77 / 6-09)
� + Prescricetl by DepaM�ent ot Laal Govemmen[ Finance
1NSTRUCTIONS:
To 6e �led in person or by mail.
Fi7ing Da�es: 7J Real Property.� Musi be comp/eted and dated in Ihe calendar year tor which the deduclion is sough(.
Must 6e filed wi(h fhe County Audimr or County Recorder o( the counry where the property is focated
on or before January 5 of fhe immediately succeeding calendar year.
2) Mobile / Manufacfumd Homes not assessed as Real P�operty: Must file with the County Auditor of the
counry where the property is located dudng the fweNe (12) mon[hs before March 3f o; each year the
deduction is sought. G,�
See reverse side for adddional inshuctions and qual�ca6ons.
AppGCani (owrrer w mnfrdG buyer- see reslncGOns on revarse side)
Michael B. Helmer and Karen S. Helmer
TaxingDistricc KeynumherllegalEescnptbn
Patoka 2fr12-29-400-000.962-027 / PT SE 29 2 10 1.57 Acre
Year
Fortn filed wiN:— ��
F�1 Oaq1{yqudi:or
J L1f13
< Counry Recorder
Record number
AssesseC val�e W mal property as of Mortgage / ContraG indebtetlness unpaid as of Mortgage / Contract i`Mebtedness unpaid as o( Is �he aDW��nI the wle
Marc� 7, ament year Mardi 1, artent y�ear ;� '/ � date of appliration Dp le9al or equRable ormer?
62.200.00 � // ).�`-i �• '— � 70 /�f�� o Ye5 ❑ No
If rw, w�at i516s / her e�cl share
n/a
If name on recortl is difrerent Uian
n/a
Name of mongagee a conLaa seDer
Kirkston Mortgage Lending, LLC
Address of rtwrtgaqee or conVact seQer (numberaM stree., city, sta:e, arMZIP co0e)
501 Cross Pointe Blvd., Evansville, IN 47715
w oNer ormer or noltler of mortgage
Na
Atldress o( a55ignee (numcer and sbeel, al�; stale,
n/a
Na
wiih 5omeone other Nan spouse, irMitate wiN whom
Is the properry in quesUa
❑� Real Property ❑
I Does applicant own pfoperty in any other I If yes, what munp!� I Wtut Ta�dng Distnct7 I Has tt6s deduction Oeen requestetl rn Pmperty I
counry in Intliana? for curtent year?
n Yes ❑ No ❑ Yes ❑ No