HomeMy WebLinkAboutMortgage_Schapker e•-^—'•v STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS i County I Township Year
dam ' E i FOR DEDUCTION FROM ASSESSED VALUATION
S• Sate Form 43709(R73/10-15) 1b50 bsarlon 2017
Prescribed by Department of Local Government Finance
INSTRUCTIONS: 111 JJJ ddd.....-111 Mark
To be filed in person or by mail. n C r Q O,7 Form fled with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction i O
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is 12 County Auditor
located on or before January 5 of the immediately succeeding calendar year. /. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County tr7 of.s. 1l
': rf
where the property is located during the twelve(12)months before March 31 of each year t llsht.
See reverse side for additional instructions and qualifications. GIBSON COUNTY A DITOR
Applicant(owner or contract buyer-see restrictions on reverse side)
Schapker, Micheal J. / Glenda C 2017-4779
Taxing District Key number/legal description Record number Page number
Barton 26-20-25-200-002.180-001 NE 25-3-9 6.363 AC C-1 D-3-8-19-6 17 3485
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?
$153,000.00 $152,000.00 _ El Yes El 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
(2 Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Lynnville Community Bank
Address of mortgagee or contract seller(number and street,city,state.and ZIP code)
215 N Main St, Lynnville, IN 47619
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 on property for
in Indiana? Yes SI 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 1 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.
Signature owners full rpme � ��/� Date(month,day,year)
L i
WIF resident address s ppltcant(n•mbar lid street.city,state.and ZIP cod r
11490E 900 S LYNNVILLE, IN 47619
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)
i The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed 510.000.