HomeMy WebLinkAboutMortgage_Meyer (6) /# S' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS u Te ip I Year I
!i_,- 1 FOR DEDUCTION FROM ASSESSED VALUATION
'' State Form 43709(R11/6-09)
•
,,, ! Prescribed by Department of Local Government Finance
JUL 1
INSTRUCTIONS: 5. I File Mark
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 so t.
Must be filed with the County Auditor or County Recorder of the county where the property is 1dctQeC` unry Auditor
on or before January 5 of the immediately succeeding calendar year. r, Rc nA'NfrtYnrnN+--'JA',`-^lY2J County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property:Must file with the CouniymUa tUro A U i •
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
Taxing District Key number/legal description Record number Pag u`° r
Princeton 26-12-07-301-004.185-028/Lot 25 in Richland Forest I 2013300 0 11 00351
000358L
Assessed value of real property as of Mortgage I 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?
11 /39 5 ).Ql.) 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
Si 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 lit yes,what county? What Taxing District? Has this deduction been requested on property
county Indiana? for current year?
ry in y❑ Yes ❑ No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 1 20 20 20 20 20 20
Signal rare of County Audito/ , 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.
Signature(owner's full name)) S (Date(month,day,year)
3 tlFes~� �A �tbe, tcity state,and ZIP code) JUN 2 5 7m3
Full resident d ess of appf nt(num ran
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 stmet city,state,end ZIP code)
IIMINIMIt _ _