HomeMy WebLinkAboutMortgage_Wayman .0.^•7.a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
>4__- ° FOR DEDUCTION FROM ASSESSED VALUAT �1
-� State Form 43709(R13/10-15) ���E 05 i11 1---on • /J�/89
°•;�; Prescribed by Department ofl_ocal Government Finance ...111LLL t�/1 / �Y (N( (ff
INSTRUCTIONS: 2018 File Mark
To be filed in person or by mail. JUN 21
Form filed with:
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deductio is so ght.
Must be filed or postmarked with the County Auditor or County Recorder (the cq ere the property is ❑ County Auditor
located on or before January 5 of the immediately succeeding calend ❑ County Recorder
2)Mobile/Manufactured Homes not assessed as Real Property:�Lld yr(h El—p pi1ty- at3ThPthe county
where the property is located during the twelve(12)months bet it-t 3j'o each year the deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side) •
Corey B. Wayman , Nichole S.Wayman
Taxing District Key number/legal description Record number Pa a number
Barton 26-20-03-400-000. 001 'AS) IT �� �d44S
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
ac Pssment date,anent year assessment date,current year date of application legal ocepuitable gytper?
106,900.00 327,900.00 . 'YTI Yes LJ No
If no,what is his/her exact share of interest? I 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 ❑ Annually Accessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theater Drive, Evansville, IN 47715
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 , property for
in Indiana? Yes [ 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)
• .l/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 ful ame) Date(month,day,year)
•. . ,fib , /!� 06/18/18
Fin i ent ess of applicant(number and street,city,state,and ZIP code)
5434 S 925 E, Oakland City, IN, 47660-
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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10.000.__ R=arr