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Home My WebLink AboutMortgage_Durbin AM^biz STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township Year �._.; % FOR DEDUCTION FROM ASSESSED VALUATION 6�� Sate Form 437i)g(R 12/rr14) t�OnT I hf ' •:`&�I, Prescribed by Department of Local Government Finance gp I ( INSTRUCTIONS: To be filed in person or by mail. A 7 a Form filed with: Filing Dates: 1) Real Property Must be completed and dated in the calendar year for which the deduction is soughA PR 1 5 LO Coun Auditor Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is ty located on or before January 5 of the immediately succeeding calendar year. ❑ .unty Recorder 2) Mobile/Manufactured Homes not assessed as Real Property Must file with the County Auditor. an.i 4, where the property is located during the twelve(12)months before March 31 of each year to edu"' ' •••< !?.: M11. See reverse side for additional instructions and qualifications. u l BSO N COUNTY AUDITOR Applicant(owner or contract buyer-see restrictions on reverse side) C. Michael Durbin and Varoncia L. Durbin Taxing District Key number/legal description RergrQ ber Pgen ¢e� Johnson 26-22-12-300-002.318-024 I '�InC t/lJ Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the ap t the sole March 1,cunrert year March 1,current year date of application legal or equitable owner? $237,900.00 ❑ Yes ❑ No If co,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 ❑ Real Property ❑ Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Old National Bank Address of mortgagee or contract seller(number and street.city,stare,and ZIP code) One Main St. Evansville, IN 47708 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? on property been requested If yes,state amount of deduction other county current ear ❑Yes ❑No other Indiana? ❑Yes 0 N Y 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 I 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 aforem, ,oned property on date application is filed. $W . sfW fie) / / _ Date( th04/06/2016 /h:.v - I it '• Full resident address of applicant(number and street,city,state,and ZIP code) 1389 W. Wheatland Ct. Haubstadt, IN 47639 Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year) Address of authorized person (number and street.city,state.and ZIP code) The penalties for penury can include imprisonment up to two and a half years and a lime not to exceed S10,000. a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ,�``?� County Township Year FOR DEDUCTION FROM ASSESSED VALUATION nn Prescribed by Departnent5of Local Government Finance IF F..I IL � File Mark INSTRUCTIONS: �� `` To be filed in person or by mail Faro ith: Filing Dates: 1) Real Property Must be completed and dated in the calendar year for whicpghg)deductre)$, sough'. Must be flied or postmarked with the County Auditor or County Recorder cifth 'cvLnty khLlt§the property is II/�� 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 wig/he Gouty Lire county where the property is located during the tweh'e(12)months before March deduction is sought. See reverse side for Atonal instructions and qualifications. GIBBON COIINTY AUDITOR • Applicant(owner or on rave de) UD OR �� , T D Key number/legal Remrd page "? L. a(�-aa /a-390 —era-3i3 —aq , f vatue of real property as of Mortgage/ 'indebtedness unpaid as of - Mortgage/Contract indebtedness imp as of Is the apps ant the sole cloth,current year as h di�agre�.year date of ap n legal or equable owneR Y'(��V)`L.)�/ll ❑ Yes ❑ No If no,what is his I her exact share of interest? / If awned with someone other than spouse,indurate with whom If name on record is afferent than that of applicant,indurate below: Is the property in question:Annually Assessed ❑ Real Property ❑ AnnuatyAssessed Mobie Home(tC 61.1-7)•None of mortgagee or contract seller Y\1 Address of mortgagee or contrail seer(number and street ray,s63e��a) Name of assignee or other owner or holder of mortgage Address of assignee(number and street,city,state,and ZIP code) • fa*/cot - 0,1-0/G — /rf e 7 what Taxing Diana? Has this deducron been requested t yes,Stith amount a deduction bn p for ❑im Yes 0 N 0 L NA-1-1°44 19-n nit- - - in has a balance on the person's mortgage or contract indebtedness that is recorded in the county that is recorded in the county recorder's office)that is the basis for the deduction. Drawer NO COUNTY AUDITOR Card NO. . — 20 20 20 20 Signature of County Auditor County Date(month,day,year) I f 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. S (owners hill name) (\ n Data(month,day,year) /"\t LO It-CA-6A rV N L -031-(.4.- ;Full resident address of applicant(number and sheet,city,dale and P code) 13' I W r (A)h Ot)Ct1/4di ( - i auloc -04 �)1N 416,39 Person authorized by duly executed Power of Attorney or by IC 6-I.1-12-a7 Date(month,day,year) Address of authorized person (number and street ply,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.