HomeMy WebLinkAboutMortgage_Armstrong (3) .�. •�F STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
ov�,.�9 County Township Year
4.- - FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R13/10-15) FILED
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by maiL S E P .+ 5 2019 Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sough.
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
where the property is located during the twelve(12)months before March 31 of eacfumt bti.? tp ITO R
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Megan Ann Armstrong and Corey Allen Seifert
Taxing District Key number/legal description R d r Pa u7�er
Union Township 26-18-24-300-000.733-025 9/5
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?
$296,875.00 ❑ 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
❑ Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
US Bank, N.A.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4801 Frederica St Owensboro, KY 42301
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? ❑YesNo current year? ❑
LI
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 Auditor County Date(month,day,year)
I 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 afor entioned pro erty on date application is filed.
Si ature o er's full nam Date onth,day,year)
Full sident ad.r: s of app scant(number and street,city,state,an code) f
1141 W400 S, Fort Branch, IN 476
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.enalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.