HomeMy WebLinkAboutMortgage_Kinsall,� ^,�o , STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
?a��� FOR DEDUCTION FROM ASSESSED VALUATION
%t�� State Form 43709 (R71 I 6-09) 51 �
� :� Prescribed by Department of Local Govemment Finance /'� FII�MBf}C 9 ZQ�2
" NK 1
1 UCTIONS:
To be (lled in person or by mail.
Filing Dates: i) Real Pioper(y.� Must be completed and daled in the calendar year tor which the deducfion is sought.
Must 6e filed with the County Autlitor or Counry Recorder ol the county where lhe property is locafed
on or befo2 January 5 0l the immediately succeeding calendar year.
2) Mobile /Manu�actured Homes nof assessed as Real Property.' Must (!e wilh the County Auditor o/the
aounty where fhe property is bcated dunng the hvelve (72) months belora Maroh 31 0l each yea� the
deduction is sought.
See reverse side for additional instructions and qualificalions.
Applicant (owner orcontract buy�.y- see 2stnctions on reverse side)
Sander M. Kinsall and Elislc. Kinsall
River
ed value of real property as
7, curreni year
on
Key number / legal descriplion / Pfoperty �
5305 N 200 W Patoka, Indiana 47666
7, wrtent year
,845.00
Third Mortgage Company
�ss of mor�qagee or contract seller (number and street
i S Cicero Ave, Ste 302, Oak Lawn, IL 60453
� of assignee or other owner or holder of mortqage
applicant own pmperty in any other IF yes, what a
y in Indiana?
❑ Yes ❑ No
ction appmved in the amount of:
20 _ 20 _ 20 _
I/ We certify under penalty of perjury that the above and foregoing
owner / coniract buyer of ihe aforementioned property on date app
ignaNre�owners/// /�� r aN / N� l- /�
� �
and street, ciry, state,
N 200 W, Patoka, IN 47666
o�
person
Form le i .
ia�N cbtfld4�'�`f1 6R
County Recorder
number
as of IMOrtgage / ConVact indebiedness unpaid as of Ils Ne applicant Ne sole
tlate of applicalion legal or equitable ownel?
9 Yes ❑ No
vned wiUi some0ne oiher �han 5pouse, indiWte wilh whom
Is Ne property in quesUOn: Mnualty lvssessed
B Real Property ❑ Annualty Assessed
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I�-aony
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on ti-�9-�a
estetl on properry
Yes ❑ Na
20 _
ont of Indiana and