HomeMy WebLinkAboutMortgage_Devoy (2) ra STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
et-._ s FOR DEDUCTION FROM ASSESSED VALUATION
S' � State Form 43709(R13/10-15) 911).&O b'tiKA IZOt�1'> Prescribed by Department of Local Government Finance `
INSTRUCTIONS: File Mark
To be riled 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 A.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 he deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Devoy, Richard and Andrea
Taxing District Key number/legal description Record mber Page number
White River 26-02-58-033-003.050-018/Pt Md 33-1-10 1.40 AC ILI-d3 (p
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
ar--^"e„t date,anent year assessment date,current year date of application legal or eguita owner?
',4 Oq 400 55500.13 112000 rir—es ❑ No
It no,what is his/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 the erty in question:Annually Assessed
eal Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name mortgageeof or contract seller FILED
Regions Bank dba Regions Mortgage
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
2050 Parkway Office Circle, Birmingham, AL 35244 JUN 1 4 2019
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street.city,state,and ZIP code) (,�q¢(�t�} rr� u.7
Does applicant own property in a It yes,what county? What Taxing District? Has this deductio4114Pretpm&P L 1r ye f 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 approved in the amount of:
20 20 20 20 20 20 20
Signature of County A it t0 County Date(month.day,year)
+�� Bl� 6 -lkt -t`il
II We certify under the penalty of perjury that the abo c .;JTui€going information is a and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
tgnature niers full name) //�� Date m°''th day, ear)
_ r1xCCCL fCYrl@l, lN�lC
FXull/�sident address of applicant(number and street, rty state,and ZIP code)
A )7."T easy ,2C2rlc✓ Pe_l< ,c 7,/P.I)rl. /in (19040
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.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.