HomeMy WebLinkAboutMortgage_Vencel or rte`. STATEMENT OF MORTGAGE OR CONTRTI y TN B SS • County Township Year
' ` FOR DEDUCTION FROM ASSESSED VA On
State Form 43709(R11/6-09) Gibson Fort Branch 2012
Prescribed by Department of Local Government Finance
APR 10 2013 File Mark
INSTRUCTIONS:
To be filed in person or by mail. Form fled with:
Filing Dates: I) Real Property:Must be completed and dated in the calendar y-s t,, i...:.%-g1)f;W pductiornn�yyiiss sought.
Must be filed with the County Auditor or County Recorder of tin " -'' i 'LpropeOF4s located ❑ County Auditor
on or before January 5 of the immediately succeedingGd2��I-- ❑ County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Anthony&Megan Vencel
Taxing District Key number/legal description Record number Page aMpume(t
Fort Branch Township 26-19-19-101-000-964.026 Lot 7 in Smith's Enlargement 211)1300001643
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1.anent year March 1,current year date of application legal or equitable owner?
24300 128400 13 Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Quicken Loans Inc.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
1050 Woodward Ave. Detroit MI 48226-1906
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street.city.state,and ZIP code)
Does applicant own property in any other II yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
ty ❑ Yes TA No y
❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20_ 20_ 20_ 20
Signature of County Auditor County Date(month,day,year)
I I We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
i• r,owners Ionia Date(month,day,year)
�,,', //r Q ���,J��'^.'�(�^)' 04/08/2013
Full r= dress di applicant(number d street, ,state,and ZIP code)
505 ncoln St.Fort Branch IN 47648
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day.year)
Address of authorized person (number and street.city,state,end ZIP code)