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HomeMy WebLinkAboutMortgage_Mills (2) e^t v, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year 3a '� FOR DEDUCTION FROM ASSESSED VALUATION Prescribed by Department of Baal Government Finance INSTRUCTIONS: i i I ti-IP: To be filed in person or by mail with the County Auditor of the county where the property is located. Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. C n I 2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)monthsSiBrr$.a 18 of each year the deduction is sought. See reverse side for additional instructions and qualifications. vn/ Applicant(owner or contract buyer-see restrictions on reverse side) r,�j James veaon, rersonal Rep-ofinetslaLe UIHazerveacR -,phrrr-"t r. R. ra t 1418SON COUNTY AUDITOR Taxing District Key number/legal description Record dnnu_ r Page nurryber,� Ft. Branch Township 26-19-18-302-000.818-026/Lot 18 Hillcrest Addition 1 'l) 7`/7 U 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 I,current year March 1.current year date of application legal or equitable owner? $81,000.00 © 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 ©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) 1 Main Street, Evansville, in 47708 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 It yes,what county? What Taxing District? Has this deduction been requested on property county in Indiana? 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 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) Date(month,day.year) - - I2. k/sy / 3 Full reside address of applicant(number and street,city state.and ZIP code) 604 E. Sinclair St., 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.city,state,and ZIP code)