HomeMy WebLinkAboutMortgage_Claridge Jr ..x°•*0, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
°/ FOR DEDUCTION FROM ASSESSED VALUATION
r• State Form 43709(R13/10-15) Gibson hton I I
-., Prescribed by Department of Local Government Finance +' / _• ;�'.
INSTRUCTIONS: File Mark
Drr p
To be filed in person or by mail. –FamOriled 21h1/
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 p PA❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the qc
where the property is located during the twelve(12)months before March 31 of each year the deduction is bWN." T(A.UQ:TO!(
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jerry R. Claridge Jr. and Julie A. Claridge
Taxing District Key number/legal description Rnrd number Page number
Johnson 26-23-16-100-001.974-024 S C{
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 date,current year date of application legal or equitable owner?
254,500 223,911 p 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
Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
myCUmortgage, LLC
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
3560 Pentagon Blvd. Suite 301, Beavercreek, OH 45431
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,stare,and ZIP code)
Does applicant own property i ny 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 I contract buyer of the aforementioned property on date application is filed.
igna:ure(offer's me� /f Date(month,day,year)
r l ,d e /
ti
Full sident address of appli nt(number and street,city,state,and ZI code)
12373 S 200 E Haubstadt, IN 47639
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)