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HomeMy WebLinkAboutMortgage_Crance �� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township � Year Ili E FOR DEDUCTION FROM ASSESSED VALUATION - 1' State vibe 4by D par ma15) FIT e;� Prescribed by Department of Local Government Finance J�®(1 INSTRUCTIONS: To be filed in person or by mail. rm filed with: Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sough-MAR 1 9 20 Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is -9 County Auditor located on or before January 5 of the immediately succeeding calendar year. . ■ -•un Recorder 2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of.1: 17 •••��m11 until where the property is located during the twelve(12)months before March 31 of each year the dedur t OU 'TY AUDITOR See reverse side for additional instructions end qualifications. 1.i X199 SS Applicant(owner or contract buyer-see restrictions on reverse side) CRANCE, DONALD F. Taxing District Key number!legal description Record number Page number HAUBSTADT 26-23-06-101-000.114-009 /3 - /I/:), Assessed value of real property as cf Mortgage!Contract indebtedness unpaid as of Mortgage!Contract indebtedness unpaid as of Is the applicant the sole assessment date,anent year assessment date,current year date of appliaticn legal or equitable owner? $90,000.00 El Yes u No If no.what is his/her exact share of interest? If owned with someone ether than spouse,indicate with whom If name on record is different than that of applicant,indite below Is the property in question:Annually Assessed l Real Property ❑ AnnualyAssessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller OLD NATIONAL BANK Address of mortgagee or contract seller(number and street,city,slate,and ZIP code) ONE MAIN STREET, EVANSVILLE, IN 47708 Name of assignee or caner owner or holder of mortgage Address of assignee(number and street,city,state,and ZIP code) Does applicant own property in an If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction other county on properly for in Indiana? ❑Yes No current year? CI 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 ot. 20 I 20 I 20 I 20 f I 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 contract buyer of the aforementioned property on date application is filed. Signatu,• v - s full name). (]„..,_ / Date(month,day,year) ae 0-/ a GO 03/09/2018 Fuil resident address of applicant(number and street,cry,state,and ZIP code) 202 W. STATE ROUTE 68, HAUBSTADT, IN 47639 Person authorized by duly executed Power cf Atorney or by IC 6-1.1-12-0.7 Date(month,day year) Andress 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.