HomeMy WebLinkAboutMortgage_Boze STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Townshi. Year
e �_ ' FOR DEDUCTION FROM ASSESSED VALUATION 51 2014
State Form 43709(R11 /6-09)
' Prescribed by Department of Local Government Finance ! l it e •
rau I ( I
INSTRUCTIONS:
To be filled in person or by mail. APR . LU. Forp 14 with:
Filing Dates: 1)Real Properly: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 County Auditor
on or before January 5 of the immediately succeeding calendar year. / ❑ my Recorder
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor ofh the
county where the properly is located during the twelve(12)months before March 31 of each year the COUNTY AUDITOR
deduction is sought ti B
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Theresa Ann Boze
Taxing District Key number/legal description 26-14-18-403-001.127-007/110 South Record number Page number
Gibson Street, Oakland City, Indiana 47660
O ale--#'49
v 26-14-18-403-001.127-007 A/4 / 361
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?,
S47,621.00 .6Yes ❑ 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 apphcant,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
American Financial Resources, Inc. and The Secretary of Housing and Urban Development
Address of mortgagee or contract seller(number and street city state and 7IP code)
11503 Springfield Pike, Cincinnati,OH 45246
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
Signa re 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.
Signa r owner's full name) Dat (month,day,year)
(L1 •se
Full resident address of applicant(number and st : t.city,state, and ZIP code)
110 South Gibson Street,Oakland City, IN 47660
Person authorized by duty 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)