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HomeMy WebLinkAboutMortgage_Stout e",no STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou jTh jIltYear �-,s' 4 FOR DEDUCTION FROM ASSESSED VALUATION `II' \,. �ei State Form 43709(RIO/n-0e) Gibson I• Johnson \ - Prescribed by Department of Local Government Finance AUG 13 2013 INSTRUCTIONS: File-Mark To be filed in person or by mail with the CountyAuditor of the county where the property is located. Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. e -If 2)Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)mo hs be* ••y0 g ff.) ch.:•�6R the deduction is sought. CCii CC U UU See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Brian R.Stout and Melinda J Stout Taxing District Key number/legal description Record umber agelwmber Johnson 26-23-16-300-000.756-024 Pt NE 1/4 SW 1/4 16-4-10 /3 �� Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage I 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? 224,263.00 ❑ Yes El 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 belcw. Is the property in question:Annually Assessed ©Real Property ❑Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Top Flite Financial, Inc Address of mortgagee or contract seller(number and street.city,state,and ZIP code) 123 E Grand River Ave.,Williamston,MI 48895 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 Inciana? for current year? ❑ Yes No ❑ 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/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 I contract buyer of the aforementioned property on date application is filed. Signature(ownersj 11 name) �p Date(m 01.d •,year) 20 878 P3 Full resident address of applicant(number and street,city,state,and ZIP code) Person authorized by duty 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)