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HomeMy WebLinkAboutMortgage_Meeks STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS I try Township Year etA FOR DEDUCTION FROM ASSESSED VALUATION —tad/i'' State Form 43709 Department/11-08) Prescribed by Department of Local Government Finance I INSTRUCTIONS: ? 9 203 File Mark To be filed in person or by mail with the County Auditor of the county where the property is locate Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. 2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the if elv- . f,jfl. s1E March 31 of each year the deduction is sought. De pU p 1• See reverse side for additional instructions and qualifications. C,(BSON COON Applicant(owner or contract buyer-see restrictions on reverse side) Cad R. Meeks and Lisa J. Meeks Taxing District Key number/legal description Re ord number Page number Center Township 26-13-18-300-001.365-004/Pt SE SW 18-2-9 Sd0 3 yg V / Ac sled 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? $98,188.00 © 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 German American Bancorp Address of mortgagee or contract seller(number and street,city,state.and ZIP code) 711 Main Street,Jasper, IN 47546 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? 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/contract buyer of the aforementioned property on date application is filed. Signs a(ow eta full name Date(month,day,year) ' �?'�. �+ I7lee � JUI 31 2013 Full resident a dress of applicant(number and street,ci tte,and ZIP code) 5887 E 155 S, Francisco, IN 47649 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)