HomeMy WebLinkAboutMortgage_McDonald 2r. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township I Year
" FOR DEDUCTION FROM ASSESSED VALUATION S la-t9 y�
State Form 43709(R13/10-15) Gibson 20/F
Prescribed by Department of Local Government Finance iil\`i P dY... 1Qligokoacct&
File Mark
INSTRUCTIONS: Form filed with:
To be filed in person or by mail.
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought. ❑ County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the ❑ County Recorder
property is located on or before January 5 of the immediately succeeding calendar year.
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)
Timothy B. McDonald
T Oq District Key number/legal description Rgord numer P m�er
FrLt Pted 26-17-09-200-004.621-021 LO14 !if
(�j16
atue of real p perry as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as o Is the applicant the sole
assessment date,a1 year assessment date.current year date of application l�egal equitable owner?
201,188.00 Sues 0 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
eal Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or gland seller FILE �,,,\
Bank of England 0
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
PO Box 3490, Little Rock, AR 72203
Name of assignee or other owner or holder of mortgage MAY 6 Z019
Address of assignee(number and street,city.state,and ZIP code) 4
Does applicant own property in an If yes,what county? What Taxing District? i tie uesstted If yes,state amount of deduction
other county /J'" GIFi on property
l 1
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 ap roved in the amount of:
20 20 I 20 20 20 20
eutat
Signature of u h ditor Ill County
...k) Date(month,day.year)
vy\
I/We certl under the penalty o perjury t at the above and g information t5 Qde and correct and that the applicant is a reside t of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signatu wne ll n e Date(month,day.year)
/��/� /7//3�Qj 05/03/19
FullTesident a s561 applicant(num�street city,state,and ZIP code)
9621 W 575 S, Owensville, IN, 47665
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.