HomeMy WebLinkAboutMortgage_Manners a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year
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a v 1 I FOR DEDUCTION FROM ASSESSED VALUATION
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State Form 43709
Department F �Ei
,� - 1 Prescribed by Department of Local Government Finance
INSTRUCTIONS: F1 1 ile Mark
To be filed in person or by mail. DEC : °£64' w'th'
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 ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. I I♦ ••un Recorder•2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the .:11; ,kiIAij/ ty
where the property is located during the twelve(12)months before Mardi 31 of each year the detigg8 we�U NTY AUDITOR
See reverse side for additional instructions and qualifications.
Applicant(owner Cr contract buyer-see restrictions on reverse side)
Jared D. Maners and Brittany K. Maners
Taxing District Key number/legal description RecgW number Page number
Princeton Township 26-11-12-102-002.989.028 a0 1•A- Sao
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contact indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of application legal or equitable owner?
142373.00 p 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 question:Annually Assessed
Real Property ❑ AnnuallyAssessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seter
Fifth Third Mortgage
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
5050 Kingsley Drive, Cincinnati OH 45227
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 District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes 2rNo 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 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/contract buyer of the aforementioned property on date application is filed.
Signature(owner's lull name) Date(month,day,year)
rAn_--- , ...17116,----6-- Uo 1r 3 o Zit -7
Full re nt address of applicant(number rH street,cr s te,and ZIP code)
310 N. Third Ave., Princeton, IN-Z7670
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Data(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 510,000.
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