HomeMy WebLinkAboutMortgage_Vaughn (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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FOR DEDUCTION FROM ASSESSED VALUATION 51 2014
% f, State Form 43709(R11 /6-09) •
��J Prescribed by Department of Local Government Finance I -ii
INSTRUCTIONS:
To be filled in person or by mail. Form filed with:
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed with the County Auditor or County Recorder of the county where the property is located OCT 2 8 2014 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. G I B S O N COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Rick A.Vaughn and Tammi L.Vaughn
Taxing District Key number/legal description 26-23-16-100-001.60-024/12344 South Record number Page number
Brook Drive, Haubstadt, Indiana 47639
Country Ayre,Gibson County, Indiana �{1/�7
26-23-16-100-001.960-024 00111 .91/ '—
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?
S208,000.00 O 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
O Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Commerce Bank
Address of mortgagee or contract seller(number and street city state and 7IP rode)
20 N.W Fourth Street, Evansville, IN 47708
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 O 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 u penalty o�t the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementione p operty on application is filed.
ature(owner's full name // Date(month,day,year)
Full resident address of applicant(nu an s eet,cit,st e,and ZIP code) f
12344 South Brook Drive, Haubstadt, IN 4763
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,city,state,and ZIP code)