HomeMy WebLinkAboutMortgage_Hoover (2) i, sieW,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County . Township Year
�':, \'a FOR DEDUCTION FROM ASSESSED VALUATION
/.,' = 1 ,. ' 2019
x\r )t State Form 43709(R13/10-15)
'\ Prescribed by Department of Local Government Finance File Mark
rate
INSTRUCTIONS: •
To be filled 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 ❑
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property is located on or before January 5 of the immediately succeeding calendar year. • County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor of the ❑ County Recorder
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 S. Hoover and Jennifer A. Hoover .
taxing District Key number/legal description 26-13-34-400-000.330-006/4401 S.Taleia Reco u b r Pag
r fip
Dr. Oakland City, Indiana 47660 l
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?
$155,200.00 ❑Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
i
If name on record is different than that of applicant,indicate below: Is the property in question: Annually Assessed
0 Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Commerce Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) •
320 Eagle Crest Dr, Suite E, Evansville, IN FTT ED : .
Name of assignee or other owner or holder of mortgage •
Address of assignee(number and street,city,state, and ZIP code) DEC 1 0 2019 .
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Does applicant own property in any If yes,what county? What Taxing District? Has this kl-duction ee vess ed If yes,state amount of
other county on prop-c' i i deduction
in Indiana? 0 Yes 0 No C# et6 laliMAUDI-M118Io
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
r ecorder'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.
I COUNTY AUDITOR
Deduction approved in the amount of:
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•
20 20 20 20 20 20
Signature of County Audito County \
Date•month,day,year)
6 \0.I GJoi,
1/We certify under pena y of perjury tha a above and foregoing information'sd true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property n date a plication is fil d.
Si r o is 7e) Date( onth,day,year)
_ ai1z1IIq
ull resident address applicant(number and street,ci y,st e,and ZIP de)
4401 S Taleia Dr., Oakland City, IN 47660
Person authorized by duly executed Power of Attorney or b IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person(number and street,city,state,and ZIP code)
Tho nonaihac fnr npritiry can include imprisonment uo to two and a half years and a fine not to exceed$10,000.