HomeMy WebLinkAboutMortgage_Blanton STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Court f:al Zalt�,'ll1C1111' -.n1
, _. FOR DEDUCTION FROM ASSESSED VALUATION 1 s'
State Form 43709(R11/6-09)
Prescribed by Department of Local r;ovemment F 2014
INSTRUCTIONS: F Ned with:
lb be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought dtor
2)Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months I BS O N Ud6TiMytickEtfa�R
before March 31 of each year the deduction is sought
See reverse side for additional instructions and qualifications.
Applicant( or rad buyer-see ' •ns on reverse side) �.p
63__l 11 3 ` c�1 C31
Taxing District . num0 /regal description Record number Page number
1p. _,_....0 . _ lo- - - sca 11 - b mob. Obi • 4 ..
Assessed vaje of real. as as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the appfiarrt the sole
current March 1,at year r March 1,current year date of application legal ortaMe owner?
S b nn�
If no,what's his I her exact sham of interest? If owned with someone other than spouse,indicate with whom
If name on record is different Nan that of app6rant,indicate below. Is the property in question:Annually Assessed
• meal Property ❑AnnualyAssessed
' Mobile Home(IC 6-1.1-7)
Nzif mortrgagee or contract seller
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Address of or contract seller(number and street city,state,and ZIP code)
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Name of assignee or other owner or holder of mortgage
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Address of assignee(number and street oily.slate,and ZIP code) Il��•[
Does applicant own property in any other If yes,what county? , D Y a"et ✓/ �••.•••• wasted an prop rty
county in lndbna?
C1 yes t o •.�..1..•••' 1 Yes 1E No
I Cot CCt" �
Deduction approved in the amount of
20 20 20 20 \ 20 20 20
Signature of Canty Auditor • County Date(month,day,year)
I I We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner ...nb-act buyer of the aforementioned property on date application is filed.
Sign :es N �/n name) Date(month,day,year)
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I address of applicant(number and street,city,state,and ZIP rode)
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P--.n authorized by duty 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) .
.r °^� STATEMENT, OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION $$''��,,
. State Fartn 43709 (RB / 2-07) � � A p
�O .��. � F'resa�baE bY.DePerlmenl d Local Go�emmerrt Firiarwe �_!
File Mark
�NSrnucnoNS: MAY 1 8 2009
To 6e fiied in person or by mad wifh tl�e CourrtyAuAitor W the courtty where the property is bcated.
Fd'a�g Dates: 1) Real Property: Dunng the 12 rtronths be/ore June 17 W fhe year the deduclion is to be elfective.
2) Mobile Homes assessed rmder IC 6-1.1-7: Belween Jarruary 15 end March 2 0! the year tlre deductiarJsjq,be eReGtiyg.
See reverse side /a addtional insWcSons aiM qualifications. ��l�� F3 /'�,
qppicaN (owner d - see ra ' m re side)
�
T'rg Di �d Key munber /-egal � DI RemnE iwwmber Page rwmber
as�s�d �� ot m� p�oPaiy as d r.�a� i. amsa r� M«+aa� i com�ae u,demeaness �npaw as ot n�.a, i. is ma ��m,t u,e sde i�i « ey�ude w.,,err
�whal is his I her ezaa shara M irrteiesl?
reme m recorC is tltlferant tlian Ihat d applicarq, indi�te belox.
Addrass at mortgagee «wnVaC seller (n�mbar arM stri
Name af assgnee or Wier awner or hdder d mangege
Address ot assigrree (num6er arM sUeet. dh: stete, entl
Daes applicant own prnperty in any olher
counry in Indiana�
❑Yes ❑ No
Deduction appmved in Ihe amdml of:
,��
signature ot Couny Aud'dor
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Dra�t�er \0....`.r�`,: �........
Card NO. ... .Iq9q...
���.�..
( I
cwnry
❑Yes ❑No
spouse. indiula wiih whom.
Is the proparty in puastim:
❑ Real Prooenv ❑ MoMle Home pC G7.1
4111rs dBdUd%YI DBe� reGues�ed Ofl aopeNy
aRenl yeafl
❑Yes ❑ No
zo _ � zo _
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I/ We cerUfy under the penalty oi perjury that the above and foregoing infortr�ation is true and oorteU and ihat ihe applitants was / were a resident of
Ind�f�.aad owner of ihe aforementioned property on March 1, 20 _ � _
address of applicaN (nwnber
e,, ��
pason (num"beraMSheef,
end LP mde)
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