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Home My WebLink AboutMortgage_Jines (3) "A" - STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township • - � . � Coun Townshi Year rba`=' t FOR DEDUCTION FROM ASSESSED VALUATION ��111 ' •�• State Pori 43709(R12/8-14) J' i,Jbsof' atoka 2016 •' „„ + Prescribed by Department of Local Government Finance 1 / INSTRUCTIONS: File Mark To be filed in person or by mail. S E P 1 2015 Form filed with: Filing Dates: 1) Real Properly: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 whe e property is © County Auditor located on or before January 5 of the immediately succeeding calendar year. / .i 2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the We �• ❑ County Recorder the property is located during the twelve(12)months before March 31 of each yea ••-•�i% ii % •R)TCR See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Adam J. Jines and Megan L. Jines Taxing District Key number/legal description Record number Page number Patoka 26-11-35-300-001.114-027 a o 't5— 31 au 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'',airrent year March 1,current year date of application legal or equitable owner? 79,400 101,938 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 Waterstone Mortgage Corporation Real Property ❑ Mobile Home(IC 61.1-7) Name of mortgagee or contract seller N25 W23255 Paul Rd. Pewaukee, WI 53072 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 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? lo 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 �yf }200 \ 20 20 20 20 Signature of County Get- 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/••ntract buyer of the aforementioned property on date application is filed. Signatur. ipsfull name) 1 , �� Date(month,day,year)( Full r •ent-ddress•f applicant(number and street,city,state,and ZIP code) U 2225 ° :0 S Princeton, IN 47670 Person authorized by duly executed Power of Attorney or by IC 8-1.1-12-0.7 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.