HomeMy WebLinkAboutMortgage_DeHart (3) .Mw,, _4- STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
Y
FOR DEDUCTION FROM ASSESSED VALUATION [ 'ILgibson. Montgomery 2021
P -';`,- ,„, State Form 43709(R13/10-15)
'off - Prescribed by Department of Local Government Finance
-12)• File Mark
INSTRUCTIONS: �E
To be filed in person or by mail. ,p � Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year f ich the dedu'Lrti n'�r, yght. Count Auditor
Must be filed or postmarked with the County Auditor or Coun Rec of he county whe�'lfe property is y
located on or before January 5 of the immediately succeeding calsldgg ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file ate p6urlfr rditor of the county
where the property is located during the twelve(12)months before March 31 of a c44 Ol tion is sought.
See reverse side for additional instructions and qualifications. OFi)
Applicant(owner or contract buyer-see restrictions on reverse side)
DeHart, Stacey L. and William Cody
Taxing District Key number/legal description Rm.ord number Page number
Montgomery 26-11-31-300-004.250-021 t-► O -4'e'/5
Assessed value of real propertf Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is theoapplicant
the e sole
y as o
assessment date,current year assessment date,current year date of applicationlegal
er?
235,732 IZi 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
2] Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Heritage Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
PO Box 189 Newburgh, IN 47629
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own pr erty in any If yes,what county? What Taxing District? Has this deduc een requested If yes,state amount of deduction
other county on property for
in Indiana? es El No 6— tt;h 4 0 A. current year? r.iN Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or •nt 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)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
zo 20 zo 20 \20 20 .
ignat 2untyhudito/), County \'.33'/\ D t ( o a \
./e..ne2,iY/1-7 ..e )(1-14-4-1.4"
I/We certify under the penalty of perjury that the above and foregoing information is tru a d correct and that the applicant is resident of Indiana and
owner/contract buyer of the orem►�t`ltioned pro\-,\OLLp on date application is filed.
Signet e e' WI name) / ����ffff'''' /���J /�,,,12 Date(month,day,year)
Fullen dress pf appli t( mb r and st et,city,state, nd ZIP code)
6142 West tal eim Avenue Owensville, IN 47665 Date(month,day,year)
Person authorized by d ecuted Power of Attorney or by IC 6-1.1-12-0.7
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.