HomeMy WebLinkAboutMortgage_Spindler (2) C__-) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
^, FOR DEDUCTION FROM ASSESSED VALUA State Form 43709(R12/614) ! J Gibson Union 2016
Prescribed by Department of Local Government Finance - -- —'
INSTRUCTIONS: 11 2016 File Mark
FEB v
To be filed in person or by mail. Form filed with:
Filing Dates: I) 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 Recorde of the co4nty ,,'=•- e property is IN County Auditor
located on or before January 5 of the immediately succeeding ca/enda 1-a; • ,
q!m1. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must ry' grr®ghe county
where the property is located during the twelve(12)months be 47L&==P -- - .ddOchon is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Blake A. Spindler
Taring District Key number/legal description Record number Page number
Union 26-19-18-303-000.591-026 ✓ ao IL- S% )-
Assessed value of real piuperty as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of application legal or equitable owner?
110,200 100,500 ✓ 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
Mortgage Masters of Indiana, Inc. 0 Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
501 Cross Pointe Blvd. Evansville, IN 47715
Address of mortgagee or contract seller(number and street,dry,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 in ny If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county ,�/p on property for
in Indiana? ❑Yes L�/No current yeah ❑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 20 20_ 20 20 20
Signature of County Auditor County Date(month,day,year)
I t 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.
i�natureNl name) Datenyt,day, laca
Full resident address of applicant number and street,dry,state,and ZIP code) lllj�`ll ((/l/l
307 E. Locust St. Ft. Branch, IN 47648
Person authorized by duly executed Power of Attomey or by IC 6-1.1-12-0.7 Date(month,day,year)
•
Address of authorized person (number and street,dry,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.