HomeMy WebLinkAboutMortgage_Steckler (2) ellSTATEMENT OF MORTGAGE OR CONTRACT INDETL LSE my Township Year
,..-- ' FOR DEDUCTION FROM ASSESSED VALUATION
' State Form 43709(R11/6-09) MAY 15 2014 Gibson Haubstadt 2015
�;�„^' Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail. �t Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar yearl$yae 4he t(or iA�'nR
Must be filed with the County Auditor or County Recorder of the county where the property is oca ea County Auditor
on or before January 5 of the immediately succeeding calendar year. ❑ County Recorder
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.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jeremy Wayne Steckler
Taring District Key number/legal description Record number Page number
Haubstadt 26-19-31-303-000.330-009 Pi- / 9 g Li
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?
110,100 165,306 GI 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
GI 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,ofy,state,and ZIP code)
711 Main St.Jasper, IN 47547
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 N No ❑ yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20_ 20_ 20_ 20 20 20
Signatu of County Audi_or 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.
Sig ature(owners/u0 name) / Date(month,day.year)
yC.�rf.(!!t/- 05/12/2014
.ull residen ddress of applicant(number and street city,state,and ZIP code)
309 S Vine St Haubstadt, IN 47639
Person authorized by duly executed Power of Aaomey 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)