HomeMy WebLinkAboutMortgage_Hoefling (5) ^•-y STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
°a__ FOR DEDUCTION FROM ASSESSED VALUATION
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State Form 43709(R12/6-14) Gibson FIFE 016
\ % Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be filed in person or by mail. MAR l9mm fint5h:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is Z County Auditor
located on or before January 5 of the immediately succeeding calendar year. ecorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of tilApq n
where the property is located during the twelve(12)months before March 31 of each year the deduction fig$ /.COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jason C. Hoefling and Alicia M. Hoefling
Taxing District Key number/legal description 1161
u m 1�
Fort Branch 26-18-13-403-000-793.026 p
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract inde ness unpaid as of Is the applicant the sole
March 1.current year March 1,current year date of application legal or equitable owner?
129,000 ' 135,850 p 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
Heritage Federal Credit Union E Real Property ❑ AnnuallyAssessed
9 Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
5388 Old State Hwy 66, Newburgh, IN 47630
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
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 If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes No current year? ❑Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction.
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/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/contract buyer of the aforementioned property on date application is filed.
Sigyslure(owners full mt2ume //,, ,, � ��1/� ii ,r Date(month,day,year)
" l' .tkwt tA,J A,a ZIP co '}t , (mil/ ly{/I^' 3/3/2015
ul sident address of applicant r and street,city,state,and ZIP code)
02 W. Locust St. Ft. Branch, IN 47648
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)
. The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S10,000.