HomeMy WebLinkAboutMortgage_Helfert tat. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
\t State Form 43709(R13/10-15) Gibson Montgomery 2019
/ 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. W 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)
Michael Helfert ,
Taxi g DiSidct Key number I legal description Record nu er Pa bets.
A et-e7"cRf 26-17-19-200-000.344-021 2so k.4_ "
Sss€€sssseedticlue of rea it
as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as f Is the pplicant the sole
ascessment date,current year assessment date,current year date of application leg or equitable owner?
98,200 95,243.00 es 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: 16,6 property in question:Annually Assessed
Real Property 0 AnnuallyAssessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Bank of England �-'
Address of mortgagee or contract seller(number and street city,state,and ZIP code) FILE L �'
PO Box 3490, Little Rock, AR 72203 J
Name of assignee or other owner or holder of mortgage _ SUN 17 2019
Address of assignee(number and street,city,state,and ZIP code)
!----
Does applicant own property in a If yes,what county? What Taxing District? Has this deduction been r�gl.G efamount of deduction
other county on property for u'D N �
in Indiana? ❑Yes cJ'N0 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 I 0 20 20 20 _ 20 20
Signature of County Audit 0 I
m j County WO-con
Date(grip e'O
ct
tI/We certify underthe penalty of perjury that the abol and f Ing informatione and correct and that the applicant isd nt of Indiana and
owner/contract buyer of the aforementioned property on as a application is filed.
Signature(owners/L Date(month,day,year)
06/12/19
Full resident address of applicant(number and street city,state,and ZIP code)
7999 S SR 165, 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.