HomeMy WebLinkAboutMortgage_Geuss (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4.)f FOR DEDUCTION FROM ASSESSED VALUATION
-` t' State Form 43709(R11/6o9) I
Prescribed by Department of Local Government Finance F I L E I,.,
INSTRUCTIONS: JJJJIIII �JJJ�LLLn JL�{wrp�py
To be filed in person or by mad with the County Auditor or County Recorder of the county where the property is locaMAR 1 1 Lu I3 with:
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought ❑ County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)mont
before March 31 of each year the deduction is sought. I - 4 Ili a m. my Recorder
See reverse side for additional instructions and qualifications. fi I RSf1N COUNTY Al1l11TOR
Apptipgalm(ownerr-se�on side)
I>(``District Key number I legal description Record number Page number
-4/y)--am.-2 ?(o — a 3_05 -300 - 000."797 - bag 013 57 ,�(F/
value of real property as of Mor ge/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of ,Is the splitrant the sole
March 1,amen year 1.cement year date of apptmagon legal or equitable owner?
9a/ p00 0 Yes 0 No
If no,what Is his!her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant indicate below: Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home(IC 6r1.1-7)
Name of mortgagee or contract seller /
- l5A
Address of mortgagee or contract seller(number end street,city. to,arid ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
®T co w 5 - 9 - 10 , co t 1 g 4 G
Does applicant own property in any other If yes,what county? What Taxing District? I Has this deduction been requested on property
county in Indiana?
❑ Yes ❑ No j _
COUNTY AUDITOR CQ I
�/ 3
Deduction approved in the amount of Drawer NO
20_ 20 20 20 t�7�-/
Card NO. n "�/
Signs of Corny Auditor• II County /C2/10 O V /! I
1/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
sigraga4 @wmers h,u '/�(//Jj Date(month,day,rte)
i,/ f,/M�resiresiidd/eenntaad f applicant(numbe rd street,city,sstatee,,,and ZIP ) /_ •
\
Person authorized by duty executed Power of Attorney or by IC 61.1- U�5 -2—Ai �w I Date(month,day,year)
Address of authorized person (number and street,city state,and ZIP code)