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HomeMy WebLinkAboutMortgage_Crawford (3) e .7:4, STATEMENT OF MORTGAGE OR CONTRACT INDEBT 11 Township f Year lA FOR DEDUCTION FROM ASSESSED VALUATION 1 \,��� State Form 43709(R12/6-14) \.rte Prescribed by Department of Local Government Finance INSTRUCTIONS: SEP 2 2015 File Mark To be filed in person or by mail. Form Ned with: Filing Dates: I) Real Property:Must be completed and dated in the calendar year for which the deduc ion is sought. Must be filed or postmarked with the County Auditor or County Recorder of the coon here is ❑ County 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 cur,(rgBS Nt)Q!'/p-WthilWi T)OR 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. Applicant(owner or contact buyer-see restrictions on reverse side) Crawford, Ashley L. Taxing District Keyn- - -1 description Record Page 26-12-17-101-001.082-028/Kunkel Add II /761 jS d qfi Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the appli t the sole March 1,current year March 1,current year date of application legal or eq .table owner? 86,500.00 70,207.00 78,551.00 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 dferent than that of applicant indicate below: Is property in question:Annually Assessed Real Property ❑ Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contact seller American Financial Resources Inc., ISAOA/ATIMA and The Secretary of HUD Address of mortgagee or contract seller(number and street,city state,and ZIP code) PO BOX 202049, Florence, SC 29502 Name of assignee or other owner or holder of mortgage r-- Address of assignee(number and street,city state.and ZIP ca kh IC� C _ nO rd Does applicant own property in y If yes,what county? 1((y'�`j''(--,(/jL/r/ If yes,state amount of deduction other county mect�l in Indiana? ❑Yes No ^�,/ A person is not entitled to this deduction unless the pers ,/� ( Il l �ss that is recorded in the county recorder's office(including any home equity line of credi if C-, 551 iJ Csor cc r the deduction. Deduction approved in the amount of: (� I"1 J l5—� 20 20 20 20 20 20 20 Signature of County Auditor County Data(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 application is filed. Signatureaji lu0nom „ 1 Date(month,�aear)�� Full resident add of appr nt(number and street.dry.sta• dZIP 4,0 S bolas ,/on c9., /hce i /N 471o70 Person authorized by duly executed PowerorAtomey or by IC 6-1.1-12-0_7 r 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 510,000.