HomeMy WebLinkAboutMortgage_Luttrull I j Q STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
/ •„ ". FOR DEDUCTION FROM ASSESSED VALUATION 2018
Ste ' State Form 43709(R13/10-15)
�( IPrescribed by Department of Local Government Finance File Mark
a•
INSTRUCTIONS:
To be filled in person or by mail. FILg
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 located on or before January 5 of the immediately succeeding calendar year. APR 20� County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor of the County Recorder
county where the property 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. ClQSON t.UUNTY
Applicant(owner or contract buyer-see restrictions on reverse side) AUDITOR
Jodi C. Luttrull and Kevin W. Luttrull •
Taxing District Key number/legal description 26-11-15-101-003.952-027/2678 W. Julie Record numbe Page ni r er
Dr., Princeton, Indiana 47670 pyN\C(o JI Ut
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 egle owner?
$228,876.00 fps ❑ 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 pro in question: Annually At-rinsed
eal Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Heritage Federal Credit Union
Address of mortgagee or contract seller(number and street,city, state, and ZIP code)
5388 Old State Highway 66, Newburgh, IN 47629
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
other county / on property for deduction
in Indiana? ❑ Yes S,-`,'( 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)
/We certify under 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.
ite ature •wner's full name) Date(month,day,year)
or C l _
Full reside t address of app cant(number an street,city, state,and ZIP code) t•
' 2678 W Julie Dr.,Princeton, IN 47670
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.