HomeMy WebLinkAboutMortgage_Parker (5) /�o STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year
t �s FOR DEDUCTION FROM ASSESSED VALUATION 9 ' 3'1
(j 719PrescribedbyDepartmentof Local Government Finance \- d V l I -
INSTRUCTIONS: File Mark
To be filed in person or by mail. F rm "ad 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)
JEREMY L. PARKER AND LACIE J. PARKER
Taxis D thct Key number/legal description R P nu r
- u k dr 2J-l �3)-3o� -coo .OQ/-oo> n- 2
Assessed value of real property 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?
209,000 Vj Yes 0 No
If no,what is his I her exact share of interest? I Ifowned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: FILED Is the property in question:Annually Assessed
❑ Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller JUN 0 5,2019
GERMAN AMERICAN BANK
Address of mortgagee or contract seller(number and street,Oty,state,an. -code)
Name of assignee or other owner or holder of mortgage bitSON COU TY AUDITOR
•
•
Address of assignee(number and street,city state,and ZIP code)
Does applicant own propeny in If yes,what county? Wnat Taxing District? Has this deduction been requested If yes,state amount of deduction
other county ,L•{ 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 approved in the amount of:
• 20 20 20 20 i20 20 // 20
Signature of Court u LJ 4• �,,../) County — ^ Date(port td ¢ag
1 C\-11� vl 1 l
I/We certify under the penalty of perjury that the above an oregoing information is lr e a 1d correct and that the applicant is re dent of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature(owner's full name) t /) `� Date(month,day 9/ --
les,den Jl t ✓ • YUra t 'JC\ 01001-32 (� 04/29/2019
Fu�residen ddress of phcant(number and street,city.state.and ZIP code) (}/l
500 E GIBSON ST HAUBSTADT IN 47639
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street.aty.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.