HomeMy WebLinkAboutMortgage_Reinhart (2) M'"'^o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County 1. nshi Year
t FOR DEDUCTION FROM ASSESSED VALUATION Gibson c a " 2019
State Form 43709(R13/10-15)
SIcii d Prescribed by Department of Local Government Finance
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. 0 County Auditor
Must be riled or postmarked with the County Auditor or County Recorder of the county where the 0 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)
James E. Reinhart
Taxing District G Key number l legal description Record nuAser Pit ginger
er
26-14-18-304-000.521-007 k"� LlT1
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the pplicant the sole
assessment date,current year assessment date,current year date of application I or equitable owner?
$55,500.00 70,400.00 Yes ❑ 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 a/property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller -
Old National BankFILFJD
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
3535 N Green River Road, Evansville, IN 47715-1347
Name of assignee or other owner or holder of mortgage MAY 2 8 2019
Address of assignee(number and street,city,state,and ZIP code) _
(GI SON COUPITV At nITOR
Does applicant own property in 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 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 approv:a in the amount of: •
20 _ 20 , 120 20 20 20 20
Signature of Cou• • ditor G v County Date( t O:1 1 '
1 .` im S
I/We c-rtify under the penalty of perjury that the a oregoing information is true and correct and that the applicant a resi ent of Indiana and
owner I contract buyer of the afore ntioned property on date application is filed.
Signature(owner n e) Date(month,day,year)
� 7 05/23/19
Full resiapplicant(number and street,city,state,and ZIP code)
426 S Main Street, Oakland City, IN, 47660
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 Iwo and a half years and a fine not to exceed$10,000.