HomeMy WebLinkAboutMortgage_Lantaff d^ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
MI FOR DEDUCTION FROM ASSESSED VALUATION p
k� State Form 43709(R12/614) 5-144 1
Prescribed by Department of Local Government Finance my P at t q a ab
INSTRUCTIONS: File Mark
To be filed in person or by mail Form filed with:
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 ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the 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.
Applicant(owner or contract buyer-see restrictions on reverse side)
Denver C. Lantaff
Taxing District Key number/legal description Record number Page nu
mber
Oakland CITY TWNSHP 26-13-13-402-000.198-007 Z 1 "/7
Assessed value ofnt real property as of Mortgage I Comma indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
March 1,anent year March 1,current year date of application legal or equitable owner?
43,900.00 73,235.00 0 Yes 0 No
It no,what is his I 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
0 Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller FILED
DIAMOND VALLEY FCU
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
840 Diamond Avenue Evansville, IN 47711
Name of assignee or other owner or holder of mortgage MAY 01 2019
Address of assignee(number and street.city,state,and ZIP code) -`
Does applicant arm property in any- it yes,what county? What Taxing District? Has this ded31s3eN ! •I V yAtIrtfledpppnt of deduction — --
other county on property for V U I t lJ K
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 rcwrded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 t1\ 2 20 20 20 20
Signature of C lupityg ``\J 410Count Date(month,d yeaq
I/We certi under the penalty of perjury that the above an. -going information"s t e 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(owners Date(month,day,year)
05/01/2019
Full resident address ol applicant(number and street,city,state,and ZIP code)
126 N. Second Ave. Oakland City, IN 47660
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address ol 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.