HomeMy WebLinkAboutMortgage_Curry (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
ounty Township Year
"-e::: FOR DEDUCTION FROM ASSESSED VALUATION � ��1
�::.;. tlr State Form 43709(R13/10-15) 1
-- - Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail. Form led 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)
Curry, Max A. & Katherine A.
Taxing District Key number/legal description Record number Page number
Johnson 26-18-36-300-000.435-024 o2..3a .1 Cz Le 1,K
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?
$240,000.00 El 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
m Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
First National Bank of Carmi F 1 T �D
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) ■ J,.�/
201 E Main Street, Carmi, IL 62821
Name of assignee or other owner or holder of mortgage D EC 2 1 rf L 021
Address of assignee(number and street,city,state,and ZIP code)
'�'J2 l• A'
Does applicant own property in an If yes,what county? What Taxing DiiftisoN CC p �' n requested If yes,state amount of deduction
other county
in Indiana? El Yes o current year? Yes D No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or c n ct 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 tha is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 /�� 20 20 20 20 20 20
Signature ofgoyltyt udi or c_ CT.�\ County LS 01\ Date(month,{ ��✓ day,re L-
I/We certify under the penalty of perjury tat le above and foregoing information is tru al d correct\and that the applicant is aressiidlle t of Indiana and
owner/contract buyer of the aforementioned property on date application is filed. 1
Signature(ow er's f me) Date(month,day,year)
z / 12/17/2021
Full resid address of applicant(number and street,city.state,and ZIP code) l�r
1367 W 1000 S, Haubstadt, IN 47639
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)
-• ,.--.-- ,.,,can include imprisonment up to two and a half years and a fine not to exceed$10,000.