HomeMy WebLinkAboutMortgage_Wilzbacher (3) ems`•° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
;a ' ` FOR DEDUCTION FROM ASSESSED VALUATION
v'�' rm State Fo 43709(R11/6-09)
"• Prescribed by Department of Local Government Finance
INSTRUCTIONS: .�'� ,•.
- Sled wi .
D
Ting ad in person by mail. •
Filing Dates:: 1) Rest l Property:Must be completed
Audi and County in Recorder calendar year fury where the deduction is sought UL�7 3 City Auditor
Must be filed with the County Auditor or County Recorder of the county where the property is located t�4r z
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(1 2)months before March 31 of each year the
deduction is sought. I _ �,
' q'ml�r
See reverse side for additional instructions and qualifications. GIBSON COUNTY AUDITOR'
Applicant(owner or contract buyer-see restrictions on reverse side)
Daniel K.Wilzbacher and Jan M.Wilzbacher �/
Taxing Oisthct Key number l legal description port/ P ba.-t�-/
Union 26-19-28-400-001.879-025 /j/y`/U (/ �,f�u(
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the app,cant the sole
March 1,current year March 1,current year date of application legal or equitable owner?
125100 102900 82000.00 n 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
12 Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Regions Bank dba Regions Mtg
Address of mortgagee or contract seller(number and street.city,state,and ZIP code)
PO Box 1565,Cordova,TN 38088-1565
Name of assignee or other owner or holder of mortgage
1 Address cf assignee(number and street,city,state,and ZIP code) ,
Dees apolicant own croperty in any other If yes,what county? What Taxing District? Has this deduction been requested on property
tor current year? ❑
county in Indiana? ❑ yes No
❑ Yes No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month.day,year)
I 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 I contract buyer of the aforementioned pr y on date application is filed.
5 re(owner's full name) t (month,day.year)
it f `7 /G- /�
Fun resident adcress of applicant(number and street,city.state,and ZIP code)
2458 E 950 S,Haubstadt, IN 47639
Person authorized by duly executed Power of Atttomey 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)