HomeMy WebLinkAboutMortgage_Hill (2) 6 y mrt£ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township YeaTt
FOR DEDUCTION FROM ASSESSED VALUATION YTa � C
(/^ State Fond by De artm l t of 6-09)L lleIa�J 1.J
` •\",a�^'l Prescribed by Department of Local Government Finance
RUCTIONS:
u be filed in person or by mail. Form ad wi h:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. C 0 3 2013
Must be filed with the County Auditor or County Recorder of the county where the property is located CI Auditor
on or before January 5 of the immediately succeeding calendar year. Count Re d
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought. GIBSON COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Joshua R. Hill and Lynne M. Hill
Taxing District Key number l legal description Record number Page nuallrlt ru104nt
PATOKA 26-11-14-300-000.316-027 201300005253
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?
223200 232425 O 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
O Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
REGIONS BANK DBA REGIONS MORTGAGE
Address of mortgagee or contract seller(number and street.city,state,and ZIP code)
2050 PARKWAY OFFICE CIRCLE, BIRMINGHAM,AL 35244
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city state,and ZIP code)
applicant own property in any other If yes,what county? What Taxing District? Has this deduction been requested on property
y in Indiana? for current year?
I ❑ 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.
Xi afore(o fer's full e) D (month.day,year)
�v 9 as 13
Full reside address of applicant(number and street,city,state,and ZIP code)
2210 Columbia Estates,Princeton, IN,47670
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)