HomeMy WebLinkAboutMortgage_Bowden t, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou Township Year !
t : FOR DEDUCTION FROM ASSESSED VALUATION
Stabs lied y0D(parment) __- ,
Presented by Department of Local Government Finance
..-INSTRUCTIONS: ._ - - .. _ .. "- ' i�1 .
�pr•�,• ..
•
To be tiled in person or by mail ❑ �
Frfirg Dates: 1) Real Property Must be completed and dated n the calendar year for which the deduction is sought �L
Must be M ed or posbnadafd min the County Auditor or Courtly Recorder of the county where the property is County Auditor
located on or before January 5 of the bnmedately succeeding calendar year d��,apn�,,a&
2) Mobile/Manufactured Homes not assessed as Real Property Must fie with the County Auditor of the county �C Yl"C V IJ�ordar
where the property is located during the twelve(12)months before March 31 of each year the deduction is sought
See reverse side for additional instructions and qualifications
Appfwnt(owner or contract buyer-see restrictions on,averse stile) GIBSON(1411104403t---
11 1044
VINCENT L. BOWDEN COQ U yA"intro
Taxing R ION TOWNSHIP 26-18-13-402 000.956-026
Assessed value of real properly as at =aye I Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as d Is the applicant the sale I
Mann 1,=tent year Malth 1.arrant year date of apq:ation legal cc equitable owner?
$ 84,000.00 in Yes ❑ No
if no,what Is he/her exact share of cmcest7 If owned with someone other than spouse,indicate with whom
If name on record is airerent than that of
applicant indicate below: Is the Property in question:Anmagy Assessed
I71 Real Property ❑ Annually Assessed
Moue Home(IC 6-1.1-7)
Name of=Agapee or contract seller
GERMAN AMERICAN BANK .
Address of mortgagee or contract seller(number end street dty,state,and ZIP code) -
PO BOX 360, JASPER, INDIANA 47547-0360
Name if assignee or other owner or balder of mortgage _ .
. Address of assignee(number and sheet,dy,state,end ZIP code) .
•Does applicant own property it any d
ny Yes.what county? What Taring District? Has this rty f deduction been requested If yes,state amount of deduction
ii
other Indiana? ❑yes ❑No current year'?°P ❑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 fine of merit that is recorded in the county recorder's office)that is the bests for the deduction.
COUNTY AUDITOR
Deduction approved in the amount cif: . •
20 20 20 20 z0 20 20_
Signature at County Auditor County Date(month,day,year)
I I We certify under the penalty of perjury that the above and foregoing information is hue and coned and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is tied.
prestos— Dale(monad der, r)
08/ I'l /2015
dl resident address of applicant(number and street,city state.and ZIP code) •
404 N. Main Street, Ft. Branch, Indiana 47648
Person authorized by duly executed Flower of Attorney or by IC 6-1.1-12-0.7 - Date(month,day,year)
Address of authorized person (number and sheet,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.