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HomeMy WebLinkAboutMortgage_Hulfachor e STATEMENT EDUC IO OF MORTGAGE S CONTRACT INDEBTEDNESS i Year a . ;� '� FOR DEDUCTION FROM ASSESSED VALUATION State Form 43709(R12/6-14) w�.,�1` Prescribed by Department of Local Government Finance y� INSTRUCTIONS: FEB-131 r-Vir To be filed 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 deduction is sought. Must be filed or postmarked with the County Auditor or County Recorder of the county where the pro is • ounty Auditor located on or before January 5 of the immediately succeeding calendar year. 2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Audits,e(S(9pp©®UNTY 61 t 8 pupC�Recorder where the property 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(owner or convect buyer-see restrictions on reverse side) JOSEPH HULFACHOR AND RACHAEL E. HULFACHOR Toeing 9t Key number/legal description R n mbe Page number c ,v 6—/3 -3S-3cap -30o - 71Pa. —oof 0I 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 11979 year March 1,current year date of application legal or equitable owner? � I �� 151,200 0 Yes 0 N It 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:Annuauy Assessed El Real Property ❑ Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller DIAMOND VALLEY FCU Avis mortgagee o(anvact self ler(number and sir,el,cf)'sstatte,aand ZIP coJde�LI.�/�A p'fr lke Y 17 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 r-�r on property for in Indiana? ❑Yes Ll7 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 20 Signet (County Audit County Date(month,day.year) rnGt4 7;17n 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 aforementioned property on date application is filed. s�p�t re(owners full me ! Date(month,day,year) /x dr x� ( • f Cn,� 02/08/2017 Full den dtlres fop nt(number and street,city.state,and ZIP e) 4 0 S TALE DR OAKLAND CITY IN 47660 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 510,000.