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HomeMy WebLinkAboutMortgage_McManus ^='? STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS I County I Township I Year All. FOR DEDUCTION FROM ASSESSED VALUATION c. State Form 43709(.R12/6-14) Gibson Montgomery 2016 Prescribed by Department of Local Government Finance , rkk INSTRUCTIONS: Fir Fil ��`lll��`lll To be filed in person or by mail. Form reo wrn: 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 propenAI L 1 4 01 ounty Auditor 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 deduction is.• gin. maw) See reverse side for additional instructions and qualifications. •, m'S j. Applicant(owner or contract buyer-see restrictions on reverse side) GIBSON (.V UN I Y AUUI I UK Jonathan L. McManus and Whitney D. McManus Taxing District Key number/legal aescription Rerc number Page number Montgomery 26-17-09-200-005.046-021 I ro /5aB7b Assesses value of real property as of Mortgage/Contract indepteoness unpaid as of Mortgage/Contract inbeoteaness unpaid as of Is the appliant Inc sole March 1,current year March 1,current year dale of appliation legal or ecuiaole owner? 197,000 167,200 a Yes O No If no,what is his/her exact snare of interest? If owned with someone other than spouse,indicate wrn whom II name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed Fifth Third an e Mort a Company [7J Real Property ❑ Annually Assessed Mortgage P y Mobile Horne(IC 6-1.1-7) Name of mortgagee or contract seller 5001 Kingsley Dr. Cincinnati, OH 45227 Address of mongagee 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 stare,and ZIP code) Does applicant own property in any If yes,what county? Wnat 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 I Deduction approved in the amount of: 20 I 20 I 20 20 I 20 I 20 I 20 Signature of County Auditor I County I 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 appli - on is filed. 015 y e' I Date(month,day, /r) / 7/10/2015 s '. ,� •� Full resident a•.ress of ap . . freer.,city,stare,and ZIP r 9925 VUinyard =.:ce Owensville, IN 47665/ Person authorized by duty executed Power of Attorney or by IC 57.1-12 QC Date(month,day,year, Andress of authorized person (number and steer,city,sate,and ZIP code) The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed 510.000.