HomeMy WebLinkAboutMortgage_Zenthoefer (2) E_}.,j. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Counp I� Year
FOR DEDUCTION FROM ASSESSED VALUATION
t State Form 43709(R11/6-09)
prescribed by Department of Local Government Finance
File Mark
4111STRUCT1ONS: ,r•, I
To 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. •un Auditor
2)Mobile/Manufactured Homes not assessed as Real Property.Must file during the twelve(12)months I.
before March 31 of each year the deduction is sought 1'T'i: Recorder
See reverse side for additional instructions and qualifications. GIBSO • .F•• _
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Au. ( or contract buyer- restdrlans verse side) r
0b SYNf .9 , ,t A flaxc�v � �o
Tie. /J Key bar l d Record number Page number
/(/�!(12r -./V—"fil 03—o o%CPS V.I1 6 r)120/3 /2r
Assessed vah a of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
Merctl 1,amerd year Marr3r 1,amnt year data of application legal or equiable owner?
1/7 ❑ Yes ❑ No
If no.what Is his/her exact sham of interest? 0 owned with someone other that(spouse,indicate with wham
If name on record is different than that of applicant Indicate below: Is th property in question:Annuaq•Assessed
Real Property ❑Annually Assessed
Mobile Home(1C 6-1.1-7)
Name of mortgagee or contract setter n( /e
Address of mortgagee or contract seller(number and sweet,city,sta ,and ZIP coda)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,cult state,and ZIP cod
gp 6 ,,a ,
Lcal
Does applicant own property in any other If yes,what county? What Taring District? this deduction been requested on property
county in Indiana? for et year?Yes ❑ No
❑ Yes 0 No
COUNTY AUDITOR
Deduction approved in the amount of
20 20 20 20 .1_ _20.___I_ 20
61 ii71(oto,c�
Signatum of County Auditor ( ?l
1/We certify under the penalty of perjury that the above and foregoing informs D ra 1V C C N O O/ ✓ adiana and
owner l contact buyer of the aforementioned party on date application is fi •
Sig,% (r ) Card NO. 1 7S -
wresident address of applicant(num and street,aN,sea e,an ZIP code)
�' 7820 S a o E F�.�ia.�l ii Yx V ' ... ---
Person authorized by duly executed Power of Attorney or by IC 1.1-12-0.7 Date(month,day,year)__
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Address of authorized person (number and same;dry,state,and ZIP code) r.