HomeMy WebLinkAboutMortgage_McIntire a t.
ti c. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Court Ifitai�;�tal.
"b FOR DEDUCTION FROM ASSESSED VALUATION j 'w
Sae Form 43709(R11/6-09) _
Presented by Depabne t of yowl Government Finance AFERA4 2014 1
INSTRUCTIONS: . - - .. .. . -.
-
To be tiled in person or by marl Form Med walk
Fimg Dates 1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought �h • s 'r •
Must be filed with the County Auditor or County Recorder of the county where the property is located '„u•, r••'•P 'r •r
on or before January 5 of the urtmedlately succeeding calendar year. GIBE ON Ca•UJdrP y fittPaPR
2)Mobile/Manufactured Homes not assessed as Real Property.Must file with the Coi nt/Auditor of the
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought
See reverse side for additional bishuctions and qualuxations
Applicant(0.nerormrmad barer-see m iCions on reverse side)
Nathan G.E.McIntire and Paige N.McIntire
Taxing District Key number/legal description Record number Page number
FORT BRANCH 26-18-24-204-000-210026 PT E NE 243.11 .3484 A 00 W III 13
Assessed value of reed property as of Mortgage/Contact indebtedness rmpaid as of Mortgage/CContand indebtedness unpaid as of is the augment the sole
Mardi 1.amahtYea Mardi i.current year ,Tye flu ll 3 a.c— or ble owner?
0 Yes ❑ No
If no.what is its I her end share of trrsres'? if owned whS someone other than spouse,irtS with whom
If fame on resod is d ferart than that of eppficard,indxate below. is the property C quesdon:Annually Assessed
17 Real Property ❑AnnuaMASSessed
Mobile Home(IC 61.1-7)
Name of mortgagee or contact seller
REGIONS BANK DBA REGIONS MORTGAGE
Address of mortgagee or cowed seller(number and street,dty,stabs.and ZIP code)
2050 PARKWAY OFFICE CIRCLE,BIRMINGHAM,AL 35244
Name of assignee or other owner or holder of mortgage
Address of assignee(number end street cat,dab,and ZIP code)
Does applicant own pmpeiy in any other ryes,what county What Taring Disoict? Has n edu been requested on property
county in trdau? ❑ Yes ❑ No .ID Yes ❑ No
COUNTYAUDrTOR
Deduction approved in the amount at
20 20 20__ I 20 20 20__ 20
Signature of County Aadtr County Date(month,day year)
1 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!contact buyer of the aforementioned property on date application is filed.
Signature(owner's fu name) ore(month.day year)
v,,z~ g E �a�n t )1) . YY (ILO''2 i p43 riff t
n address of applicant( end street ay state,end ZIP e)
1007 S Main Street Fort Branch,IN,47648
Parson authorized by duty exeatad Power ofAttorey or by IC 61.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street cry,stab,and ZIP code)