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HomeMy WebLinkAboutMortgage_Taylor (8) It ,' STATEMENT OF MORTGAGE OR CONTRACT INDEBT 4 fc 11.! Township Year FOR DEDUCTION FROM ASSESSED VALUATION State Form43709(R12/6-14) Wanick Ohio 2016 Prescribed by Department of Local Government Finance MAR 2 2016 INSTRUCTIONS: File Mark To be filed in person or by mail. Form toed with: Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the d-•• 1 ..�;1.--ii I10; Must be filed or postmarked with the County Auditor or County Recorder ofdttics+••, trio"Nalifft it OR © 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 with the County Auditor of the county 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) Kyle Taylor and Melissa Taylor Taring District Key number/legal description / Re�number Page number ✓ Princeton 26-12-18-301-000.629-028 o /W /0 89 Assessed valued real property as of ' Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole March 1,current year March 1,current year date of application e legal or equitable owner? 107,123 V/ p Yes ❑ No If no,what is his I 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 Fifth Third Mortgage Company p Real Property ❑ AnnuallAse Assessed Name of mortgagee or contract seller 5501 Kingsley Dr. Cincinnati, OH 45227 Address of mortgagee or contract seller(number and street,try 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 , 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/contract buyer of the aforementioned property on date application is filed. -I a tree y erw1 n ) Date( th,da year)jeziz;crr Ful reside addre of plicant(number end street,try.stare,and de code) 52 lai a ve. Princeton, IN 47670 Person authorized by duly executed Power of Attorney 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 810,000. I