HomeMy WebLinkAboutMortgage_Stachura STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
f FOR DEDUCTION FROM ASSESSED VALUATION
\�itije State Form 43709 Department/t of 6-09)Local AC S Montgomery 2014
INS >` Prescribed by Department of Local Government Finance fin
TRUCTIONS: File Mark
To be filed in person or by mail. I1' Form filed with:
Filing Dates: I) Real Property:Must be completed and dated in the calendar year for which the derilnoryn'iyopni
Must be filed with the County Auditor or County Recorder of the county where the property is labgedi (i County Auditor
on or before January 5 of the Immediately succeeding calendar year. ❑ County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property:Must file with them Au . r o
county where the property is located during the twelve(12)months befaMair e
deduction is sought. ttSSSSUU COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Andrew Stachura and Aimee Stachura
Taxing District Key number/legal description Record number Page number
Montgomery 26-17-01-200-003.952-021 1f1lff fume t
7m innnni 65
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,current year March 1,current year date of application legal or equitable owner?
195,800 184,000 0 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
12 Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Commerce Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) .
20 NW 4th St.Evansville, IN 47708
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 to Indiana? for current year?
❑ Yes El No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20_ 20 20 20 20 20_
Signature C unty Auditor • i 4 n ,o County Date(month,day.year)
I I We certify under the`penalty 41off pp'e_rjuryy'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.
Sigma re aeries lull neon / Date( nt 13y.year)
/1L/I dr �' �2 I ',
Full resident address of applicant(number and street,city,state,and ZIP code)
4898 S.700 W Owensville, IN 47665
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)