HomeMy WebLinkAboutMortgage_Rockett Ji o STATEMENT OF MORTGAGE OR CONTRACT INDEBTED Guui t Township Year
? FOR DEDUCTION FROM ASSESSED VALUATION 1�1T �-{ Y
Sate Form 43709(R12/614) 1 b J 6 L1' Rochester 2020
��' Prescribed by Department of Local Government Finance
INSTRUCTIONS: AUG 2 3 2019 File Mark
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 deducti is sou t.
Must be filed or postmarked with the County Auditor or County Recorder of the count};/• yis IA 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 tile with �9ity,QIMM Yh aff•OR
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)
Gregory Rockett and Nicole Rockett
Taxing District Key number/legal description Record u r P e number
009 26-18-36-403-000.586-009/VVest Heights 3rd Lot 310 2U� 3100
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of application legal or equitable owner?
S175,691.00 p 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 the property in question:Annually Assessed
C] Real Property ❑ Annually Assessed
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)
2008 E Morgan Ave, Evansville, IN 47711
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own prone ny If yes,what county? Wnat Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? Yes No current year?ID ❑Yes ❑No
A person is not entitled t 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 Auditor County Date(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
i nature nets lull nam Date(month,day,year)
Pull resid address of applicant(number and street,city state,and ZIP code)
110 South Campbell Boulevard, Haubstadt, IN 47639
Person authorized by duty 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 two and a half years and a fine not to exceed S10,000.