HomeMy WebLinkAboutMortgage_Schlumpf 0".' 't STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
/ _ f 1 FOR DEDUCTION FROM ASSESSED VALUATION
f State Form 43709(R11/6-09) Gibson Owensville 2015
i Prescribed by Department of Local Government Finance Emir)
INSTRUCTIONS:
To be;fled in person or by mail. Form filed with:
Ring Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.II .{�y
Must be filed with the County Auditor or County Recorder of the county where the property is located'N 9 au4 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 tltEl, -
county where the property is located during the twelve(12)months before March 31 of each year tldd�Lt,
deduction is sought. GIBSON COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Zachary W. Schlumpf and
Taxing District Key number/legal description Record number Page number
Owensville 26-17-12-201-000.593-022 I 1--4 2 3 G )
As•<cw1 value of real property as of Mortgage/Contract indebtedness unpaid as of Mongage/Contact indebtedness unpaid as of Is the applicant the sole
March 1,current year Marcn 1.current year date of application legal or equitable owner?
58,800 65.295 GI Yes ❑ No
If no,what is his I 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
Military Family Home Loans, LLC
Address of mortgagee or contract seller(number and street,city.state,and ZIP code)
1776 West Lakes Pkwy Ste 200,West Des Moines, IA 50266
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? ❑ Yes El No for current year? ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in me 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.
41Signat - e/ me� ^ ^ ^^ ` ,o Q C ;1 Date(month,day,year)
x1A/- ^'�- Y `�.�-^r`l2^-- slsrzola
WI resident address of applican miter and meet.sir,state,and ZIP code) r
105 N.Church St.Owensville, IN 47665
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.crty stale,and ZIP code)