HomeMy WebLinkAboutMortgage_Osborne �•^r*.o STATEMENT OF MORTGAGE OR CONTRACT I E�NEVDCounty Township Year
er : FOR DEDUCTION FROM ASSESSED VALUATIO �1
t1: 51 2014
'CI� State Form 43709(R11/6-09) �� t. 'Pk File Mark
Prescribed by Department of Local Government Finance
a.•
INSTRUCTIONS: r t,el R• mm
To be filled in person or by mail.
II,; O AV�\1O Form filed with:
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the •V ja sought.
Must be filed with the County Auditor or County Recorder of the county IWO'• ••erty is located ❑ County Auditor
on or before January 5 of the immediately succeeding calendar year. CC���� ❑ 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)
Brandon R. Osborne and Amy L Osborne
Taxing District Key number/legal description 26-17-29-200-004.430-021 /8874 South Record number Page number
Meadow Lane, Owensville, Indiana 47665
Lot 5, Rolling Meadow, Gibson County, Indiana / '
26-17-29-200-004.430-021 / Si "Y 978'
Assessed value of real property as of Mortgage I 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?
$30,000.00 Q,,es ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom-'
If name on record is different than that of applicant,indicate below: Is the property in question: Annually Assessed
9eal Property ❑Annually Assessed
Mobile Home (IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union - ",T_
Address of mortgagee or contract seller Number and street city state and ZIP code)
4401 Theatre Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage D r� L yyrt y-j t /,NA t'yLt .n 2
Address of assignee(number and street,city,state,and ZIP code) "w crr/ut a Vc$ W!I
Does applicant own property in any other If yes,what county? r requested on property
county in Indiana? I 1 LOOS❑ Yes No — - / ❑ Yes ❑ No
COU
Deduction approved in the amount of:
20 20 20 - 20 20 20 20
Signature of County Auditor County Date(month,day,year)
I/We certify under 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 application is filed.
_rum o es full name) Date(month,day,year)
/7 V X ,%-
'Ful resident address of applican (number and street,city,state,and ZIP code)
8874 South Meadow Lane, Owensville, IN 47665
Person authorized by duly executed Power of Attomey or by IC 6-1.1-12-01 Date(month,day,year)
Address of authorized person(number and street,city,state,and ZIP code)