HomeMy WebLinkAboutMortgage_Candlish STATEMENT OF MORTGAGE OR CONTRACT IND F inty •
oTownship Year
l FOR DEDUCTION FROM ASSESSED VALUATION U'
State Form 43709 R73/10-15)
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„„ Prescribed by Department of Local Government Finance
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INSTRUCTIONS:
MAY 3 2018 File Mark
To be tiled in person or by mail. Form filed with:
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which th: .eductio is ., •
Must be filed or postmarked with the County Auditor or County Recorder of jt f,Y., .•—', rye)he property is ❑ County Auditor
located on or before January 5 of the immediately succeeding caler(t(a(,ye. �� � � ❑ County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property:Must'if e-wn a unty
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.
, Applicant(owner or contract buyer-see restrictions on reverse side)
Gary M. Candlish , Kristina J. Candlish
1 Taxing District
Patoka Key number/legal description Record number Page number
26-11-12-103-003.413 028 ao ( — 1Ce
I 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 o5eguitable qu�per?
127,900.00 108,400.00 LJ Yes L 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
L1 eal Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
AmeriFirst Financial
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
950 Trade Centre Way, Suite 400, Kalamazoo, MI 49002
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 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 Hi 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.
Signature(owners tun name) Date
mon j d ay yea
lerl /I/Fl ,vrf T 'd6 Ale lthAs6" Art Air- d� o l
UFun resident address of applicant(number and street.city,s tee.and ZIP code)
2007 W Brumfield, Princeton, IN, 47670
Person authorized by duly executed Power of Attomey 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 S10,000.