HomeMy WebLinkAboutMortgage_Neufelder -I• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ;l,„ownship I Year
a_,... 4 FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R12/6-14) .j y
. Prescribed by Department of Local Government Finance �il.:—ice U
INSTRUCTIONS: wC Ma , '!
To be tiled in person or by mail. C .ml with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought
gdr� Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where th ope ❑ N
located on or before January 5 of the immediately succeeding calendar year. �'�e /n�,,•,.�'• '
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the ow 1& - e C.unty Recorder
where the property is located durin the twelve(12)months before March 31 of each year the deduction is sou '��r�_
Pr perry 9 ( ) Y 9 /IV j1'-ter
See reverse side for additional instructions and qualifications. '400/
Applicant(owner a contract buyer-see restrictions on reverse side) 101j
Joshua M. and Cassandra N. Neufelder .
T trig/ Key number/I al description Rem nom Pagen
� As /\l0f-Mortgage /Al d V--s-1- 011
Assessed value of real property as of Mortgage/Ca ct indebtechtss unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of appr lion oo legal or equitable owner?
�(� , (Z) Yes ❑ No
If 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: f^�...�/ Is the property in question:Annually Assessed
ae- I X-a F- too-Wa. Liao 4) 5" ❑ Real Property ❑ Annually A Assessed
Name of mortgagee or contract seller
Hallmark Home Mortgage
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
7421 Coldwater Fort Wayne, IN 46825
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 Distract? Has this deduction been requested If yes,state amount of deduction
other county on property for
---4--- —.I]Yes_❑No _ _ current year? ❑Yes ONo
`ao (-i -)..Qt 6 p n has a balance on the person's mortgage or contract indebtedness that is recorded in the county
1 that is recorded in the county recorder's office)that is the basis for the deduction.
r76 SL (I1/4Q le("V\ , SI a COUNTY AUDITOR
ih.r.N` (��C . 20 20 20 • 20 --..
),Sc t10 0,00 ' ' T`C? County Date(month,day yew)
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 ner's roil name) Dada yea)
Full res' t address of applicant(number and street,city,state,and VP code)
-So h 450 West, Owensville, IN 47665
Person Jtorized by duty executed Power of Aaomey or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and steel,city,state,and VP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed 510,000.