HomeMy WebLinkAboutMortgage_Hedge (3)�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count
FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709 (R11 / fr09)
prescribed by department of Local Govemment Fnance
�,,,srRUCrioNS:
To 6e filed in person or by mail with fhe CountyAuditor or County Recorder of the county where ihe property is located.
Filing Daies: 1) Rea! Property: Must file during the year fr�r whieh the deduction is sought.
2) Mo6ile / Manufactured Homes not assessed as Real Prnperty. Must frle during fhe lwelve (12) months
before March 31 of each year ihe deducfion is soughi.
See reverse side for additional instructions and qualifrcations.
AppiicaM (owrar or ph6uyer - see restfictiin� on rev�se side)
T
�g�qnty Auditor
ZU IJ
�� County Recorder
AUDITOR
T' istrid wKey numher / iegal d 'pti Record number Page number
� 6- -�-aap-a.��39�-a � aoi3 �
�� ��� a¢ �p�y Mortga e/ Contract indebtedness unpaid as of Mortgage / Contrad indebtedness unpaid as of Is the appiicant the sole
� 1. ��� Ma� �. W date of applicaGon legal or equ�table owner?
��� O � ❑ Yes ❑ No
�J
If no, what is his / her exad share of interest? If owned with someone other ihan spouse, indicate wilh whom
If name on record is d�itferent than that af applicant, indiqte below:
Name of mo�qagee or contract seller /-� ��
�J
Address of mortgagee or conVact seller (num6er and streeS city, state, and ZIP codej
Name of assignee or other owner or hdder of mortgage
Address of assignee (number and sfreet city, state, and ZIP c:ode)
Does aQplicant own properly in any other I ff yes, what count�i?
county �n Ind'�ana? � Yes ❑ No
Is the properry in question: Mnually Assessed
❑ Real ProPeriY ❑ AimualyAssessed
Mobile Home (IC 6-1.
�i (1: rl
�ted on PraPertY
Yes ❑ No
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