HomeMy WebLinkAboutMortgage_Cundiff .•!^•'•,o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
°: FOR DEDUCTION FROM ASSESSED VALUATION ty yT,P ea
\•,, " State Form 43709(R12/6-14) �-y
Liars-• Prescribed by Department of Local Government Finance F J jj 4
INSTRUCTIONS:
File Mark
To be filed in person or by mail. FEB 1 •,r-'t r'
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 CountyAuditor or County Recorder of the county where the property is ❑ C•un ditor
located on or before January 5 of the immediately succeeding calendar year • /m"e' un Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the co •�-.n�'� fy
where the property is located during the twelve(12)months before March 31 of each year the deduafsee COU • - • • .
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Cundiff, Cullen T. & Jennifer M.
Taxing District Key number/legal description RRol V nu( Page
Ft. Branch 26-19-19-204-001.308-026/Indian Hills 75 Pt 19-3-10 Q `))
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 1,current year March 1,current year date of application legal or equitable owner?
121,700 116,325 164,524 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: s th property in question:Annually Assessed
Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contact seller
Guaranty Trust Company
Address of mortgagee or contract seller(number and street.city,state.and ZIP code)
316 Robert Rose Dr., Murfreesboro, TN 37129
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 a y If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other count' on property for
in Indiana? ❑Yes No current year? ❑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 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 I contract buyer of the aforementioned property on date application is filed.
Signature(owners full name,) Date(month,day,yea) -
&Ay— r d� 2-12-16
Full resident address of ap nt(number and street,city,state,and ZIP code)
7$919 5. 'rr F. F + aranc ll riv 476 Lta
Person authorized by duty executed Power of Attorney or by IC 6-.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 810,000.