HomeMy WebLinkAboutMortgage_Sanders (2) �, .. STATEMENT OF MORTGAGE OR CONTRACT INDEFEEJNb i it Township , Year _
FOR DEDUCTION FROM ASSESSED VALUATION
' `.1)-- State Fonn 43709(Rl l/6-09)
`. °'— Pr sa bed by Department of Coral Government Finance FEB 4 013
411/• File Mark
INSTRUCTIONS: //����•
To be filed in person or by mail with the County Auditor or County Recorder of the county wheaER ' sated Form filed with:
Filing Dates: 1) Real Property.Must file during the year for which the deduction is 7T`�N'' County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property.Mus 7i T112WEM9R
before March 31 of each year the deduction is sought ❑ County Recorder
See reverse side for additional instructions and qualifications.
Appisant(owrre o5 seeksfrictionscw n.reverse
Js) side)
T(�D'istrict Key number/legal description Record number Page noon
P a& /.u at,-/.2 -/7- D o 0/3 010/.3
Assessed value
of real es of Mortgage/Contract Indebtedness u,.,.,.,.,oa ui ,nutgage/Contract Indebtedness unpaid as of Is the applicant the sole
March 1,current year curtent date of application legal or equitable owner?
3 (j ❑ Yes ❑ No
If no,what Is his/her exact share of interest? (If owned with someone other than space,indicate with whom
If name on record is different than that of applicant Indicate belowr. Is the property in question:Annually Assessed
Real Property ❑Annually Assessed
,,��[-/)�'�,, J �1r ]
Mobile Home QC 6-1.1-7)
Name of mortgagee e contract seler p 0/11-e dais- 6a_A It V. 7 / O Q
7LonQ,f seller(number `
Address of norgag or contract seler(nurrdrer and street,rill;state,and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Dees applicant own property in any other If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? ❑ Yes El No for current r? ❑ Yes ❑ No
COUNTM.AUDITOR
—
Dedumon approved in the amount of:
5 Wtoi 20 20 20 ' " o�S k
20 20
Signature of County Auditor 13_5 cif) Date(month.day,year)
I I We certify under the penalty of perjury that the tat the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned pm
Signature(orgies m Date((month,day,year))
Full addr of a (rNmber and ^ t aly,state,and ZIP code) �/
-Pit/W/3
Per 's ! 1-S'i .5 //00 /i!-� i..cFivv Y76
author¢ad by duly executed Power of Apdney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and sheet cry,state,and ZIP code) .