HomeMy WebLinkAboutMortgage_Adams (5) • `•* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
' i FOR DEDUCTION FROM ASSESSED VALUATION
_ `
State Form 43709(R13/10-15)
Ste—'✓ Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed 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 ❑ 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 Re 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)
Adams, Zachariah W. and Adams, Haleigh D.
Taxing District Key number l legal description Re num Pa ny¢Iber
26-12-09-302-002.212-027 0201 1 ..2.
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage I 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?
$174,900.00 p Yes ❑ No
if no,what is his!her exact stare of Interest? If owned with someone other than spouse,indicate with whom
11 name on record is different than that of applicant,Indicate below: Is the property in question:Annually Assessed
❑J Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
USAA Federal Savings Bank
Address of mortgagee or contract seller(number and street.city,state,and ZIP code) FILED
10750 McDermott Freeway, San Antonio, TX 8288
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,dry,state,and ZIP code) JUL 2,9 1019
Does applicant own properly in any If yes,what county? What Taxing District? Has this deduction Ile, request'd , late amount of deduction
otner county on property for :, i d
in Indiana? ❑Yes ❑No current yejr4g r'tt � �'
A person is not entitled to this deduction unless the person has a balance on the person's mortgage)or CtProSbieii IJt rQ'Iecorded 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_ 2 20_ 20_ 20 20 20
1
Signature of County Auditor •
I vl 1' County Date(month,day,year)
1/We certify under th /ena of perjury that e a -foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
Sid- (ow.:is r II neme)a Date.{mdy/,� r))?
F trident address at aappppacant(number and street,d code) J
South 180 East, Princeton, IN 47670 ,
Person authorized by duly executed Power of Attorney or by IC 6-1.t-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.