HomeMy WebLinkAboutMortgage_Hanisch^'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun o i
� • FOR DEDUCTION FROM ASSESSED VALUATION
� State Fortn 43709 (R71 / 6-09)
S,w � P�esaibed by Departmen� of Laml Govemment Fitance
Fiten� 21 Z��
�NSTRUCTIONS:
\ To 6e ned in person w by mai! wiN the Co�ntyAuditor or Counry Recorder of the counry where the propeRy is located. F� ���
Fdirg Dates: i) Real Pmperty Must file d�ring fhe year for which the deduction is soughG � Counry
2) Mobife / Manufactu2d Homes rrot assessed es Real Property Must fiIe during the fwelve (12J months n CDfLnty R�rdC
before March 37 0/ each year the deduction is sought. G IB$�N c: uIINTY AU DI TO
See feverse side /or additional insWCGons arM qualficatrons.
Appfxant( rwmrvrdrl6uyer-seem�stri�ray'ops��n /re�ve"rses'ide) '^N O ,
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AssGSSeO vafire d rnal p'apeY,y as d
Metd� 1. arta�t ymr
i6ei l legal d ption Reca�d number
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IAbrtgage / Cantrati indehteCness unpaid as of Mwigage / Contraa udebtedness unpaid az of Is Ne
MarM 1, wrtent year date of appficatpff\ „ legal i
It m. what is his ! Mr esad share o1 interest?
If fume m �ewrd's EiRerent than Nat of aPP�rent,
Name m mortgagee «ca,aari sener .
�
Add2ss of mort9a9ce a cmtrad se0er (nu n
Name at assigriee w oUrer owner w MIEer of
AOtlress of assgnee (number arM stree; ciry, state,
Does epplifant wm yoperty in any oNer
munty m InOiana?
❑ Yes ❑ No
1
Deduclion approved'ui U�e amou�LL ot
20
20
Yes L1 No
Is propertyinquestwn:Mnua%ASSesseO
Rea� amaertr ❑ nrmua�yAssessed
Moa� r� nc s
sef, ciry, slate, aM LP code)
ZlPCOda)
ir y�. wnei �n�nrya wnai ra,�y o5maa �.
COUNTYAUDROR
20 20 20
Counry
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I/ We certify under the penalry of perjury that the aboveand foregoing intormation is We and cortec[ arM that the applinnt is a resident ot Indiana and
owner I contracl buyer of the faemeMbned property on date application is fileG.
�`a7+re (ownerS h�rwne) �./ _ A Date (manth. daY.Y��)
auUwraeO 6y EWy esewted Power
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or Cy
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