HomeMy WebLinkAboutMortgage_McDonald �� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
ai}"°°n� County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
\�,-� Stare Forth 43709(R72/6-14)
\e—� Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be filed in person or by mail. I U I £ 9()'R Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which he a col 1S ught.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is jCounty Auditor
located on or before January 5 of the immediately succeeding calendar ye- . � ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must rile wt.,
■,;, .trail;p,/'or of the county
where the property is located during the twelve(12)months before MEM£ •fee+ v. �(is sought.
See reverse side for additional instructions and qualifications. -� '"^
Applicant(owner or contract buyer-see restrictions on reverse side)
Patricia A. MCDonald
Taxing District Key number/legal description Record number Page number
002nsut Ile 26-17-01-403-000.056-022 a 0 Y(o— lz�S
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Marls 1.anent year March 1,cVntyfe-arr date of application legal or equitable owner?$0900 ❑ 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
❑ 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,state,and ZIP code)
1 Main Street, 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? Has this deduction been requested If yes,state amount of deduction
other county 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 I 20 20 20 20 20 L20
Signature o C unty Audito"r \R I) I r7 (�,Lly'��(,(.\J County J/ I / Date(mon7p,daYrf'e�V 16
I We certify under the penalty o_ffpeerjYu`ryttat theca ve and foregoing information is true and correct landd that the applicant is aarresiident of Indiana and
/ o e /contract buyer of th aforementioned property on date application is filed.
`{ Si hen's roll nor e) Date month,day,year)
Full resident address of applicant(number and street,city,state,and ZIP code)
206 Crestview Drive, 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 pedury can include imprisonment uo to two and a half years and a fine not to exceed 510.000.