HomeMy WebLinkAboutMortgage_Lunghuhn '4"::F t. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
�;e . ,A., FOR DEDUCTION FROM ASSESSED VALUATION
l,. .S•:State Form 43709(R13/10-15) ��
y,..,. Prescribed by Department of Local Government Finance
)9
INSTRUCTIONS: 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 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 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)
lunghuhn, Rebecca H.
Taxing District Key number/legal description Re ord number Pa u r
Patoka 26-05-32-400-001.189-027/PT SE 32-1-10 1.4781AC OR �
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sol
assessment date,current year assessment date,current year date of application legal or equitabl er?
160800 171000 J2$010- 1;8 'J Qt Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than souse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the pro in question:Annually Assessed
eal Property ❑ A . ed
F
i
M ile, . - 6-1.1-7)
Name of mortgagee or contract seller 1Regions Bank dba Regions Mortgage
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 2�19
2050 Parkway Office Circle, Birmingham, AL 35244 AUG 2
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) p' R
G 6SON COUNTY A
Does applicant own property in any yes,what county? What Taxing District? Has this deduction been requested I If yes,state amount of deduction
other county on property for
in Indiana? Yes No current year? ❑El 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)
•
Li ihLh , G s> t 8. ?3- /9
We certify u e penalty of perjury t t e above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the afore nti roperty on date application is filed.
S'fruaturs full name) Date h day,y ar)
F Ip I r�3sident address of applic t(number and street,city state,and ZIP code) r
�Y` 1 L KS & 20 a N j9/1 r,fv,t / /A/ '/ 7 4 7 b
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.