HomeMy WebLinkAboutMortgage_Neidig (2) a^v STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
t� .v °s FOR DEDUCTION FROM ASSESSED VALUATION mV P ow
14 2015
si. State Form 43709(R11/6-14) !g-ite fr airs S
d+' Prescribed by Department of Local Government Finance T rk
uu
I UCTIONS:
pA
To e 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. rl7t
Must be filed or postmarked with the County Auditor or County Recorder of the county where the JUN 1 G. 2 County Auditor
property 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 the
county where the property is located during the twelve(12)months before March 31 of each year the I • _� '�•deduction is sought. i/'11Pr
See reverse side for additional instructions and qualifications. GIBSON COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Craig A. Neidig and Trisha M. Neidig
Taxing District Key number/legal description 26-23-16-100-002.246-024/ 12335 S 200 E, Record number Page number
9 Haubstadt, Indiana 47639 -10V-;— aL{�3
26-23-16-100.002.246-024 I
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage I 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?
$140,000.00 17 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
I 1 Real Property ❑Annually Assessed
Mobile Home (IC 6-1.1-7)
Name of mortgagee or contract seller
Banterra Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
133 Cross Pointe Blvd., Evansville, IN 47715
0 N me of assignee or other owner or holder of mortgage
ss 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
other county on property for deduction
in Indiana? ❑ Yes O No current year? ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20_ 20
Signat re of County Audito/r .— County Date(month,day,year)
I/We certify under penalty of-ppee•rjrjjuur`y that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/co tract buyer of the aforementioned property on date application is filed.
sigrr@tpre • n 11 n, Date(m th, y-yea
Full resident add ss of applicant(n ber and street, city, state,and ZIP code) V
12335 S 200 East, Haubstadt, IN 47639
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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.