HomeMy WebLinkAboutMortgage_Schulten 41 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township Year
FOR DEDUCTION FROM ASSESSED VALUATION f
4 State Form 49709(Re 2/6-14) JoJ� Q
' �• Prescribed by Department D of Local Government Finance f@SI� ! J
INSTRUCTIONS: I e Mark
To be filed in person or by mail. C r1 o Fpmrfded with:
Filing Dates: 1) Real Property Must be completed and dated in the calendar year for which the deduction is sought. S E r 2 0 LU I U
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. .an,lf Recorder
2) Mobile/Manufactured Homes not assessed as Real Property Must file with the County Auditor of the 1ty
where the property is located during the twelve(12)months before March 31 of each year the deduction .
See reverse side for additional instructions and qualifications. GIBSON COUNTY AUDITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Gregory C. Schulten and Lora A. Schulten
Taxing District Key number nzimberl legal description R �number Pa/ r
Center 26-13-33-400-000.665-004-
6-13-33 400-000.665-004 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,anent year March 1,current year date of application legal or equitable owner?
$239,500.00 El 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 telcv. Is the property in question:Annually Assessed
EI Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
First Security Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
313 Frederica Street Owensboro, KY 42301
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,coy,sate.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 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 1
owner/contract buyer of the aforementioned property on date application is filed.
Signature(owner's lull name) Date(month,day.year)
~ L 08/25/2016
Air Fufl re • ent add Hof applicant(number and street,ci ,state,and ZIP code)
4077 S. 850 E. Oakland City, IN 47660
Person authoreed 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 perjury can include imprisonment up to two and a half years and a fine not to exceed S10,000.