HomeMy WebLinkAboutMortgage_Kremer (2) t n R STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
�fs�a
E v,_ ` FOR DEDUCTION FROM ASSESSED VALUATION
y 1� 2013
i State Form 43709(R11 16-09)Prescribed by Department of Local Government Finance
k
INSTRUCTIONS: AUG 3 n U
To be filled 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.
Must be filed with the County Auditor or County Recorder of the county where the property is located /1r ❑ aunty Auditor
on or before January 5 of the immediately succeeding calendar year. rder
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditorgf N COI NTY AUD?fQrx'v Reco
county where the property is located during the twelve(12)months before March 31 of each ye e
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side) -
Jason A. Kremer
Taxing District Key number/legal description 26-19-10-100-000.536.025/2774 East 600 Record number Page number
South, Ft. Branch, Indiana 47648 (l 3 4688 4
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?
$94,400.00 ' ,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
p-fteal Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Federal Credit Union
Address of mortgagee or contract seller(number and street city,state,and ZIP code)
6209 Vogel Road, Evansville, IN 47715
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? -- JJ for current year?
❑ Yes ENO ❑ 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 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.
("nature(owner ate(month, ay,yea
Full resident address of applicant(number agistreet,city, state,and ZIP code)
2774 East 600 South, Ft. Branch, IN 47648
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,dry, state,and ZIP code)