HomeMy WebLinkAboutMortgage_Yarbor F STATEMENT MORTGAGE CONTRACT INDEBTEDNESS Coun co.ns_ it Year
!elfFOR DEDUC TIO N FROM ASSES SED VALUATION
State Fonn 43709(R12/6-14)
Prescribed by Department of Local Government Finance
•
INSTRUCTIONS: JN I r
To be filed in person or by malt arm a-•'�'.:
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 property is � Co Hy Audi or
located on or before January 5 of the immediately succeeding calendar year. IL'r, ; I?!-p�.�,Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of tOI
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 contract buyer-see restrictions on reverse side)
Yarbor, Leslie A.
Taxing District Key number/legal description Record number Pag mber
Princeton 26-12-06-304-001-698-028/Chas Brownlee 23 pt r Al� �rj
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unvafd'as of Is the applicant a sole
March 1,current year March 1,current year date of application legal or equ a owner?
62,900 52,800 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 thspoperty in question:Annually Assessed
RI teal Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Movement Mortgage
Address of mortgagee or contract seller(number and sheet,city,state,and ZIP code)
841 Seahawk Circle, Virginia Beach, VA 23452
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 in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county , property for
in Indiana? ❑Yes No current year? ❑Yes 9 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 20 20 20 20 20
Signature of County Auditor 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/contract buyer of the aforementioned property on date application is filed.
sin ur ( nerd ss r an ame (�...(� �(��.,/ Date(month,delay,year)
\I 1( '� k - - 201 VP
Full res rtnt dress of plica (num errand street city,state,and ZIP code)
x v )brig c �t-
Person authorized by duly executed Power of"money or by IC 6-1.1-12-0.7 Data(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.