HomeMy WebLinkAboutMortgage_Georges STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coon?kW . own latirATEM
a FOR DEDUCTION FROM ASSESSED VALUATION ,,
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Prescribed by Department of Local Government Finance
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lxsrRUCnoxs:
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To be filed in person or by malt Forrn Ned with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. •
Must be filed or postmarked with the County Auditor or County Recorder of the county where /a�°�pe t;••. j4,q ,e,' •udder
located on or before January 5 of the immediately succeeding calendar year. Utt1SON COON y Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must tile with the County Auditor of the county . • -
while the properly 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(amero-contract buyer-see restrictions on reverse side)
Georges, Robert V & Katrina K. 26-20-36-400-000.370-001
Taring District Key number/legal description Record number Page number
Barton PT SE SE 36-3-9 5.01 AC c7cod /726
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage I Contrast Indebtedness unpaid as of Is the applicant the sole
assessment date,aaterd year assessment date,arnent year date of appecation legal or equitable owner?
41,760 //de o'oZ p Yes ❑ No
If no,what Is his/her exact share of Interest? It awned 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
Farm Credit Services
Address of mortgagee or contract seller(number and street,city.state.and ZIP code)
15747 Neeley Street, Evansville, IN 47725
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street city,state,and ZIP code)
Does aapp own property in any If yes,what county? what raving District? Has s this deduction been requested If yes,state amount of deduction for
In Indiana? ❑Yes O No arreerd year? ❑Yes A 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 Dale(month,day.year)
I I We certify under the penalty of perjury that the above and foregoing information is taste and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sign- ._ • nets tut name) Date(month,day,year)
10-24-2016
all resident address of: • rant(n , •4 and street,dry stale,and ZIP code)
10457 S 115f E, Lynnville, IN 47619
Person authaaed by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Data(month,day,year)
Address of authorized person (number and street city,slate,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.