HomeMy WebLinkAboutMortgage_Meyer (5) aa•f�v STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS FL Ju� inT ip I Year I
l FOR DEDUCTION FROM ASSESSED VALUATION gyB%y�S�yN
• State Form 43709(RU/6-09) I L
+•' l Prescribed by Department of Local Government Finance I i
INSTRUCTIONS: JUL 5, File Mark
I
To be filed in person or by malt Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is so t. ,unty Auditor
Must be filed with the County Auditor or County Recorder of the county where the property is �(
�'P /�Ir
on or before January 5 of the not assessed succeeding calendar year. pens, �t�UN a County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property:Must file with the Court AU i to
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)
Ryan K. Meyer mm�
Taxing District Key number l legal description Record number Pa9l t t UMellt
Princeton 26-12-07-301-004.185-028/Lot 25 in Richland Forest 20130nn035L .
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?
• W 135c I556•0) 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
O Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Old National Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
1703 W. Broadway, Princeton, IN 47670
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? for current year?
ty ❑ Yes ❑ No y
❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 1 20 20 20 20 20 20
Signet resigner re of County Auditor County I Date(month.tlay.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.
Signature(owners full name) 1 Date(month,day,year)
K t{ JUN 2 5 Intl
Fun resident d ess of app(i nt�b4r and'sfreet city,state,and ZIP code)
330 S. 1st St.,Princeton,IN 47670
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 I Date(month.day.year)
Address of authorized person (number and street city,state,and ZIP code)
a