HomeMy WebLinkAboutMortgage_Beuligmann (2) • 5-P--",' �, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4/1'
1 - t�' FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R13/10-15) Gibson Montgomery 2019
`i"e%J Prescribed by Department of Local Government Finance
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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. 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)
Matthew Bernard Beuligmann , Denia Marie Beuligmann
Taxing District Key number/legal description Record number Page number
Montgomery 26-17-01-400-003.702-021 and 26-17-01-400-003.700-021 2o lc( 4,648
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?
$174,900.00 and $9,600.00 240,350.00 ma's 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: Is t property in question:Annually Assessed
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) FIT 174
10750 McDermott Freeway, San Antonio, TX 78288 —•
-
Name of assignee or other owner or holder of mortgage NOV aI 9 1 8 2019
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 deductiorthIgg ti-�r-;u 4Ye Y B,X('au4e arnounAof deduction
other county on property for t ...''
in Indiana? ❑Yes ❑No 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 Countyyz% County 1 Date(month,day,year)
s Auditor Sm1fin Svrl 11" ^1`('
I/We certify under the penalty of perjury at 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.
Sig r(ayure(owner's full name) Date(month,day,year)
I )n I n 1V j &AfitAAAP\
i 11/12/19
Full resident address of applicant(number atreet,city, : . - -nd ZIP code)
5239 S State Road 65, Owensvill-, N, 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. • 43379