HomeMy WebLinkAboutMortgage_Hall (6) ,"�^.nv STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
ea .. FOR DEDUCTION FROM A N
i i� State Form 43709(R11 /6-09) �� DUL� NTE qEp ((lq ��y 2014
/ acceptance for transfer
Iola
INSTRUCTIONS: DEC 2 3 2014 day of
To be filled in person or by mail. Form filed with:
Filing Dates:1)Real Property:Must be completed and date. the,cal: da -- • which the deduction is so I. q ,
Must be filed with the County Auditor or Co.rT'�,y r.--(4;:ri k a county where the property is CcittutibPiudifor
on or before January 5 of the immed g qc j (M'Y- r�kyp�laho --'�"'1'`'� ❑ G� m,o go
2)Mobile/Manufactured Homes not assessed as Real-r..e P. Truttf1fe with the County AUddlgaldhp rder
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)
Steven B. Hall and Jennifer D. Hall
Taxing District Key number/legal description 26-18-36-300-002.204-024/ 10206 South Record number Page number
Prit..W.j Quail Crossing, Haubstadt, Indiana 47639
Lot 92, Hunters Crossing, Section 2, Gibson County, Indiana
26-18-36-300-002.204-024 i//
�- 553(p
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?
$203,979.00 D 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
D Real Property ❑Annually Assessed
Mobile Home (IC 6-1.1-7) -
Name of mortgagee or contract seller
Flagstar Bank, FSB
Address of mortgagee or contract seller(-number and street cite state and 7IP rode)
5151 Corporate Drive,Troy, MI 48098
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 D No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20_
Signatu a of Coon ,`�y,�,,. 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 roperty on date application is filed.
S�i9/��Iature ere full q e) fin r-� r� `^ ,� p Date(mogth.��9T V
4P/resident address of applicant(number and street,city, state,and-Z�'jP'.\Cdj_d�'e) tv�J1. (XV\`0.X ` //Z
10206 South Quail Crossing, Haubstadt, IN 47639
Person authorized by duly executed Power of Attomey 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)