HomeMy WebLinkAboutMortgage_Faraone .�-<a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
R-. = FOR DEDUCTION FROM ASSESSED VALUATION
♦ r State Form 43709(R11/6-09) F (bs � ��I="ubstadt 2014
• !• Presaibed by Department of Local Government Finance n�
INSTRUCTIONS: .1 mile Mark
To be filed in person or by mail. SEP 0 4 2013 Form sled 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 s located 4 County Auditor
on or before January 5 of the immediately succeeding calendar year. t • f .i County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property:Must file with the County • -t.;•
county where the property is located during the twelve(12)months before MarceM3gotecyciu 1 TY AUDITOR
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Dominic E. Faraone and Justine L. Faraone
Taxing District Key number/legal description Recor/q�n7umber P nu�'/ben
Haubstadt 26-22-01-202-000.345-009 c9v ( /
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Centred indebtedness unpaid as of Is the applicant the de
Math 1,current year March 1.current year date of application legal or equitable owner?
89,500 75,920 O Yes ❑ No
If no,what is his t 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
0 Real Property ❑AnnuallyAssessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Fifth Third Mortgage Company
Address of mortgagee or contract seller(number and street,dry,state,and ZIP code)
5001 Kingsley Dr.Cincinnati,OH 45227
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? Vanderburgh for current year?
l7 Yes ❑ No r9 ❑ 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 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.
Sign��s+++++��gg(owners lull name) Date(month,day.year)
0!/ ,p (! - 8!3012013
Full resident address of applicant(number and street,city,Si e110/1 /(J Dv(aC,and ZIP cod
504 W SR 68, Haubstadt, IN 47639
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)