HomeMy WebLinkAboutMortgage_Herald /°-r=ns STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coup j j;S1 ship,,
117E_ 71 t FOR DEDUCTION FROM ASSESSED VALUATION - , r �
State Fort 43709(R12/6-14)
c•`-• es Prescribed by Department of Local Government Finance
INSTRUCTIONS: Fi e •ark2O/?
To be filed in person or by mail. / Form filed with:
Filing Oates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is soug((t1�� I , ,. .i
Must be filed or postmarked with the County Auditor or County Recorder of the county where the pfrr$Se ••'4" '• • •••itor
located on or before January 5 of the immediately succeeding calendar year. CO ,..-00
i! un Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county • I Uj a -
where the properly 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.
Applicant(owner or contract buyer-see resrrfctions on reverse side)
JACOB A. HERALD AND STEPHANIE J. HERALD
Taxing District Key number/legal description Record number Page number
FT BRANCH 26-19-18-301-000.223-026 ao t"\_ Ln (Qy
Assessed value of real property as or Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as or Is the apptranf the sole
Mamtt 1.current year March 1,current year date or application legal or equitable owner?
127,600 180,808 0 Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
'Ina me on record is different than that of applicant,indicate below: Is the property in question:Annuaey Assessed
0 Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
CONSUMER REAL ESTATE FINANCE CO.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
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 a 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 o 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 AUDROR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,year)
I 1 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! tract buyer of aforementioned property on date application is filed.
nature( ner' I n me Date(month,day,yea,j
i � 7�( 10/30/2017
Full re ent address of applicant(number and street,city,state,and ZIP e)
310 E JOHN ST FORT BRANCH IN 47648
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)
The penalties for perjury can include imprisonment up to two and a half years and a fine•not to exceed$10,000.