HomeMy WebLinkAboutMortgage_Edwards (2) na STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
t_ ° FOR DEDUCTION FROM ASSESSED VALUATION 4n
kI A State Form 43709(R13/10-15) Gibson dotJtgom 18
`° A. Prescribed by Department of Local Government Finance AAAA 11lllRiiiii
INSTRUCTIONS: Ake Mark
To be filed in person or by mail. I� o' 'da:lit,•,h:
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 property is Co my Auditor
located on or before January 5 of the immediately succeeding calendar year. !r. ''' •ij- .'.un Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of my where the property is located during the twelve(12)months before March 31 of each year the deduction is sought O ' ' • •• R
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Taylor A Edwards and Jessica L Edwards
Taxing District Key number/legal description Record number Page number
Montgomery 26-17-12-400-001.792-021 / -1‘19c/
Assessed 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,current year assessment dare,current year date of application legal or equitable owner?
182,100 187,625 El 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
p Real Property ❑ Annually Accessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
United Wholesale Mortgage
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
1414E Maple Rd., Troy, MI 48083
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street city state,and ZIP code)
Does applicant own9perty in y 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/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( wnner's full n me) Date(month,day year)
Full 'dent address of applicant(num er and street, ,' `state,and ZIP code)
6452 S SR 65, Owensville, IN 47765
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 310,000.