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HomeMy WebLinkAboutMortgage_Schroeder (2) a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year 'Mil FOR DEDUCTION FROM ASSESSED VALUATION 7 State Form 43709(R13/10-15) i n 1 hnson 2018 \°, 5 Prescribed by Department of Local Government Finance INSTRUCTIONS: ark 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 RR 2017 Must be fled or postmarked with the County Auditor or County Recorder of the county where t e Yopfrtf 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 County Audito the co where the property is located during the twelve(12)months before March 31 of each year the d " See reverse side for additional instructions and qualifications. (MASON COUNTY AUDITOR Applicant(owner or contract buyer-see restrictions on reverse side) Galan T. Schroeder and Shelby Schroeder Taxing District Key number I legal description Record number Page number Johnson 26-19-35-400-000.629-024 020)7- 9a 3 Acc<ssed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole assessment date,anent year assessment date,current year date of application legal or equitable owner? 7,100 43,920 D 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 Fl Real Property ❑ AnnuallyAccessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Evansville Teachers Federal Credit Union Address of mortgagee or contract seller(number and street,citt,state,and Z/P code) 4401 Theater Dr. Evansville, IN 47715 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 ben requested If yes,state amount of deduction other county Vanderburgh SCOri' onrentye property? I ❑No 3 C)O0 in Indiana? w,Yes ❑No current year? LL11N Yes r 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 owner/contract buyer of the aforementioned property on date application is filed. Signature(gwners full name ^ Date(month,day,year) G/i/!/w.. J, !iu 2121 I Full resident address of applicant(number and street,city state,a d ZIP code) 11615 Breckinridge, Evansville, IN 47725 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. •