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HomeMy WebLinkAboutMortgage_Bailey 4,4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year ,.ter- 1 FOR DEDUCTION FROM ASSESSED VALUATION Stale Form 43709(par/6-16) got Montgomery 2017 ,• Prescrbed by Department of Local Government Finance File Mark INSTRUCTIONS: To be fled in person or by mail. Form filed with: Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the ded}? itn 4g Must be filed or postmarked with the County Auditor or County Recorder of the county;Whre�?4h ldperty is © 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 Co yAudit of ermty where the property i s located during the twelve(12)months before M a r c h 31 of ea 1 i s sought. See reverse side for additional instructions and qualifications. AIRSON ('Oi I NTY AUDITOR Applicant(owner or contract buyer-see restrictions on reverse side) Devyn R. Bailey and Krimson R. Bailey Taxing District Key number/legal description Record number Page number Montgomery 26-11-30-200-004.010-021 • aekL a-4S l 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? 108,000 96,224 a 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 Stockton Mortgage Corporation GI Real Property ❑ AnnualyosC&1.1-7) Name of mortgagee or contract seller 88 C Michael Davenport Blvd, Frankfort, KY 40601 Address of mortgagee or contract seller(number and street.city.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 a If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction other county on property for in Indiana? ❑Yes o 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/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/--•ntract buyer of the aforementioned property on date application is filed. Signatu�=comer's fua y{ 00/(1Q,/ Date(month,day year) Fun dr • umber and street,city.state,and ZIP code) 2532 S Old SR 65 Owensville, IN 47665 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.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.