HomeMy WebLinkAboutMortgage_Parish • °E STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
.a__- FOR DEDUCTION FROM ASSESSED VALUATION
Sty State Form 43709(RN/6-09) Gibs w 2013
�9� Prescribed by Department of Local Government Finance Ile f��
INSTRUCTIONS: �L 'l 8q !I
To be filed in person or by mail. Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. PR 2Cd3nty Auditor
Must be filed with the County Auditor or County Recorder of the county where the property is located CCJJ
on or before January 5 of the immediately succeeding calendar year. El Co nt = rder
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. GIBSON COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Donna R Parish NKA Donna R Head _-
Taxing
District 'Key number/legal descriptio• �SU' re orev eio.Qo,3—OG7o2 Record number Instrument) • r
Owensville Township Pt Lot 22, 25&24 Warrick's Enlargemen 201300002132
Assessed value of real property as of •r •r . in.-. -.n• ..-- - of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of application legal or equitable owner?
49,600 46,500 Fl 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
0 Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Wells Fargo Bank NA
Address of mortgagee or contract seller(number and street.city,state,and ZIP code)
2701 Wells Fargo Way, Minneapolis, MN 55467
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 If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? ❑ No Vanderburgh for current year? ❑ Yes ❑ No
Yes
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/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.
Signs re( ner's full name) �/� Date(month,day,year)
ti ,t yi4c(L) i And 04/25/2013
Full resident address of applicant(number and street,city,state,and ZIP code)
3809 Debbie Lane, Evansville IN 47711
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,and ZIP code)