HomeMy WebLinkAboutMortgage_Meny (2) ..n'nv STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County lownship Year
?�� '� FOR DEDUCTION FROM ASSESSED VALUATION
• 2015
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S iI State Form 43709(R11/6-14) ]] !!!����1'' e' Prescribed by Department of Local Government Finance J irk i j'
INSTRUCTIONS:
To be filled in person or by mail. fiiled with:
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought MAR 2 3.4
Must be filed or postmarked with the County Auditor or County Recorder of the county where the County Auditor
properly is located 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 t
county where the property is located during the twelve(12)months before March 31 of eachGy`'gra N COUNTY AUDITOR
deduction is sought. 55
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
John E. Meny and Lisa Marie Meny
Taxi District Key number/legal description /9566 East Base Road, Oakland City, RRlo Page ngm
( o caw Indiana 47660 a , -(3-//_boo-caoo-5SA . 00 (, (^//, IJ I ��((11
Assessed value of real property as of Mortgage I Contract Indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sol
March 1,current year March 1,current year date of application legal or equitable owner?
$70,000.00 ID 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
() Real Property ❑Annually Assessed
Mobile Home (IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state, and ZIP code)
6209 Vogel Road, Evansville, IN 47715
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? Mat Taxing District? Has this deduction been requested If yes,state amount of
other county on property for deduction
in Indiana? ❑ Yes El No current year? ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20_ 20_ 20 20_
Signature -e of County Auditor County Date(month,day,year)
I 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 aforementione roperty on date application is filed.
Si atur (ow ers hill name) /J(1 Date nth,tl y yea
Full r i ent address ofFpl c'NO
nt numbe d street,cit,state and ZIP code)
7.61 `-2
9566 East Base Road,Oakland lty, IN 47660
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$10,000.