HomeMy WebLinkAboutMortgage_Wilson (8) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township- Year
-.IF''CAIN FOR DEDUCTION FROM ASSESSED VALUATION
J Start Form 03709(R73/70-75)
S -t Prescribed by Department of Local Government Finance
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INSTRUCTIONS:
pars �_ .n -
Tone filedN person orbymall. j `r.1yl'�
Ring Dates: 1) Real Properly Must be completed and dated in the calendar year for which the deduction is sought L tt ditor
Must be Ned or postmarked wait the County Auddor or County Recorder of the county where the property is
located on or before January 5 of the Immediately succeeding calendar year. ,�p}.gty, Recorder
2) Mobile/Manufactured Homes not assessed as Reel Property Must file with the County Auditor of the countd U N [U 1/
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.
Appident(owner or contract buyer-see reswcdiens on reverse side)
Wilson, Monte Joe & Emma L. C.I Snks couwla pj
Taxing District Key number/legal description Record number ?`' Q�
Montgomery 26-18-07-100-001.973-021 Pt NW 7-3-11 11.42A /7' t7�-4 /0
Assessed value of reel property as of Mortgage I Contract Indebtedness unpaid as of Mortgage?Contact indebtedness unpaid as d Is the appl" e e
assessment:da•.e.patent year assessmentdata,current year an of application legal cr eq•' le owner?
133,700 0.00 • 95,000 Yes ❑ No
If no.what is his/her=ad share of incest? Iff owned with someone other than spouse.indicate with whom
If name on record Is d ferent than that of applicant Indicate be:pw: Is property in question:Annually A sen c
- '
Real Property ❑ An/Ito-1y Assessed
Mobile Horne(IC 6-1.1-7)
Name of mortgagee or contact seller
Regions Bank dba Regions Mortgage
Address of mortgagee or contact seer(number and street city,state.end ZIP code)
2050 Parkway Office Circle, Birmingham, AL 35244
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street city,state,and ZIP code) •
Does appacant ow re city in any If es,what county? `hfint Taxing District?. Has this deduction been requested if yes.state amount of deduCen
other couny I en property for
c.Indiana? Yes ❑No (_:0‘\).S15-7\ mi:reht 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 recprers office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 '20 20 20 20 20
Signabme of County Auditor County Da_(monde 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.
Slq�g3rrJ(o—'.,0 fu8name) rt �0 Q ate(.^rar�a/.year)ey's
Ful toed . address of applica.^,t(number and street,dry•slate,and ZIP code) t\. ,(��1 4-7 )
Person W Lk OD Sor by IC :2d 7 Vt l.� ' 1 (0 'Date(month.dsy,Ya%rt
Address of authorized person (number and street,dry,state.and ZIP code) _
The penalties for perjury can include imprisonment up to two and a hall years and a fine not to exceed 510.000.