HomeMy WebLinkAboutMortgage_Nichols (4) e j^;no; STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
E% \ FOR DEDUCTION FROM ASSESSED VALUATION i
1 1 State Form 43709(R13/10-15)
\1:i:--;` Prescribed by Department of Local Government Finance
INSTRUCTIONS: Ile
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To be filed in person or by mail. Pc m1 file(]wi.•ry-j
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought a tt A,.._,J il 6
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is LI County Auditor
located on or before January 5 of the immediately succeeding calendar year. C C 1 county Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must tile with the County Auditor of the couhgrP 1 9 r Ill
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 rest,cdons on reverse side) ./IL.
Nichols, Donna Jo JJ7!(
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Taxing District Key number/legal description Record number Page number
Oakland City 26-14-18-201-000.868-007/Harden Add #2 20 07, 0 / S7 - _),z 9
Assessed value of real properly 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?
65900 78360 84579.19 el Yes 0 No
If no.what is his I her exact share of interest? It owned with someone other than spouse.indicate with whom
If name on record is different than that of applicant,indicate below: Is thefroperty in question:Annually Assessed
(�,fteal Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of pongagee or contract seller
Stec s Lending, LLC
Address of mortgagee or contract seller(number and street.city state,and ZIP code)
4 Hutton Centre Dr., 10th Fl., Santa Ana, CA 92707-8788
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 It yes,state amount of deduction
other county on property for
in Indiana? ❑Yes No current year'? ❑Yes ❑No
A person is not entitled t 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 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/contract buyer of the aforementioned property on date application is filed.
Sgn9lure eivu�0-not erp ) Da:9mon'In)iea
Full resident address of a1/p`p4a',ant(numb and street,cry stare,an ZIP code) l
530 Is� I�iCSL C . aIR-L-1 cy-rcct_ O 1(j WU (1-710ifin
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. •