HomeMy WebLinkAboutMortgage_Kramer (8) �a 74,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4.,_- 1 FOR DEDUCTION FROM ASSESSED VALUATION
S'� - State Form 43709(R11/6-09) GIBSON WHITE RIVER 2017
��,�„�' Prescribed by Department of Local Government Finance IL ED INSTRUCTIONS: File Mark
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 thcsfedixtfori gWought.
Must be filed with the County Auditor or County Recorder of the county whera,tdl0 ploerfy is located ❑ County Auditor
on or before January 5 of the immediately succeeding calendar year. El County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County u . the
county where the property is located during the twelve(12)months before M ar the
deduction is sought. NTY AUDITOR
See reverse side for additional instructions and qualifications. GIBSON COU
Applicant(owner or contract buyer-see restrictions on reverse side)
KRISTOPHER V. KRAMER
Taxing District Key number/legal description Record number Page number
WHITE RIVER 26-05-58-056-002.449-018 201, - -19 So
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 1,current year March 1,current year date of application legal or equitable owner?
83,800.00 128,000.00 128,000.00 ❑ 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: Is the property in quesiori:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
FIRST NATIONAL BANK OF CARMI
Address of mortgagee or contract seller(number and street,city,stale,and ZIP code)
201 E. MAIN STREET, CARMI, IL 62827
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own properly in any other If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑ ❑ No
Yes ❑ Yes ❑ No
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 I contrac buyer of the aforementioned erty on date application is tiled.
Signature(ow Aname) fl Daten 1,./,d f year),
Full resident address of pplicant(number and street,city,state,and ZIP code)
Person authorized by duty 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)