HomeMy WebLinkAboutMortgage_Sparkso' ""•.a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
°i_ ` FOR DEDUCTION FROM ASSESSED VALUATION
• `�.�'j State Portn 43709 (Rt1 /6-09)
--'= Prescnbed by Depanment of Lowl Govemment Finance
INSTRUCTIONS: �
Count Township Year
i a
be filed in person or by mail. d"th �
��g Dates: 7) Real Pmperty: Must be completed and dated in the calendar yea� lor which the deduction is sought. � County Auditor
Must be filed with the County Audifor or County Recorder of the county where the property is located �q"
on or belore January 5 07 the immediately succeeding calendar yeac � ,�c�oF.rtecorder
2) Mobile / Manulactured Homes not assessed as Real Property: Musf file wifh the County Audifor of the •�
tounty where the property is located dunng the hvelve (12) months belore March 37 0/ each year [he C�� �
deduction is sought �
See reverse side tor additional instructions and qualifications. �
Appliwnt (ownerorconfrdU buyer- see resfiUions on ieverse side)
Kelly Sparks
Tar.ing DiSCntt
FL Branch
26-19-18-101-000.278-026 Little York Village 4/5 PT Phase 1
Record number
Assessed value of real properry as of Mort9age / ConVaa indebtedness unpaid as of Mortgage / Convaci indebtedness unpaid as of Is the appliwnt Ue wle
March 1, artent year March 1, arrent year date ol appliwtion legal or equifable owner?
146800 144154 ❑� Yes ❑ No
It no, what is his / her exact share of interest? If owned with mmeone oNer than spouse, indicate with whom
If name on record is tliRerent than that of appiicant, intlicate below. Is the pmperty in question: Mnualty Assessed
❑Q Real Property ❑ MnualtyPssessed
Name of rtwrtgagee or wntract seller
mortgagee ar contract seller (number and street, cify, uate, and ZIP code)
other owner or holder of mortgage
(numberand sl2ef, uty, sfafe, and ZIP Code)
appliwnt own property in any other If yes, what
y in Indiana?
❑ Yes No
Has Nis detluction been repuested on property
for current year7 ❑ I
❑ Yes
COUNTY AUDITOR
Deduction apprwed in the amount of:
20 20 20 20 20 _ 20 _ 20
Signature ol Counry Auditor Counry Dare (rtanfh, day, year)
I I We certify under ihe penalty of perjury Ihat the above and foregoing informafion is We and correct and that the applicant is a resident of Indiana and
owner / wntract buyer of the aforementioned property on date application is filed.
Sign ownel lull n me) Date (month, day, yea�
02/10/2012
Full re en address of appliwnt (number an0 slree(, city, state, and ZIP code)
708 E Park Street, Ft. Branch, IN 47648
Person authonzed by duly executed Power of Attomey or by IC G1.7-12-07 Date (month, day, yea�
Address of auNOnzeO person (numbe� and s12ef, city, slafe, and ZIP code) '