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HomeMy WebLinkAboutMortgage_Conrad e �p^o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year ' FOR DEDUCTION FROM ASSESSED VALUATION A__._ Sa y State Prescribed 43709 Department/6-09) �r 1 51 2014 Prescribed by Department of Local Government Fina 1Yy County Aq�l®y' File Mark rain INSTRUCTIONS: To be filled in person or by mail. q r 9() Form filed with: Filing Dates: f)Real Property:Must be completed and dated in the calendar-MI tF 76/ iE1Pt ti 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 calen year. ❑ County Recorder 2)Mobile/Manufactured Homes not assessed as Real Prope � e County Auditor of the county where the property is located during the twelgi gglpprtsj enb Wwach year the deduction is sought. See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Darren M. Conrad and Tami L. Light Taxing District Key number/legal description 26-19-29-300-001.967-025/995 E 925 S, Record number Page number C21 ,,� Fort Branch, Indiana 47648 �a/� n�n>_ vy�- y 26-19-29-300-001.967-025 `^O '� «` �" 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? $172,000.00 ©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 Ii Real Property ❑Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Heritage Federal Credit Union Address of mortgagee or contract seller(number and street.city slaty and 7lP code) 5388 Old State Highway 66, Newburgh, IN 47629 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 Signature County Auditor - County Date(month,day,year) •I f - certify under penalty 000ff_1p_erjrju y that th bove and foregoing information is true and correct and that the applicant is a resident of Indiana and ow contract buyer o h aforrQpmentione property on date application is filed. Sign. nets full name V �( C 1 ` Date(montA, d .ea�l� /t\ P / ,` V IVn\ l/U� C l Full e°- address of.pplicant(number and stre t,city, state,and ZIP code) 995 E 925 S, Fort Branch, IN 47648 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)