HomeMy WebLinkAboutMortgage_Arnold STATEMENT OF MORTGAGE OR CONTRACT
I �E rN EE un tY Townshi p Year
n vd FOR DEDUCTION FROM ASSESSED VALUATI
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State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
APR 12 2013 File Mark
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor or County Recorder of the county�y/ -re the . 'per is 1. : ed. Form filed with:
Filing Dates: 1) Real Property Must file during the year for which the deduction is so .sr,., •i
V�111r County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property���� � *tit--,- 12)months
before March 31 of each year the deduction is sought. AUDITOR ❑ County Recorder
See reverse side for additional ins dons and
qualifications.
Appecant(owner or contract b r see . ' tevepesid- // / / �A7/ /rie
Taxing etickb Key rw al descr iption Retold n ben Page
oa-��3 -�D— —ml ��S r 105
Assessed valued real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Mauch 1,cement year Mardi 1,anent year/ (j0 a> date of application legal or equitable owner?
/J- ((//l//1 ❑ No
If no,what is his/her exact share of interest? J 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 6-1.1-7)
Name of mortgagee or contract seller
673
Address of mortgagee or contract seller(number and scity.state,and ZIP code)
Name of assignee or other owner or holder of mortgage
Te
m ARNOLD f !fl IZ.k S inty? What Taxing District? for this deduction been requested ,property
_ • year? ❑ Yes ❑ No
) (-6)185
COUNTY AUDITOR
D
20 u — 1 20 20 20 20
Signature d llf I / ` County / Date(month,sy
I I 'e 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/contract buyer of the aforeemmfient�ionneeeddJproperty on date application is filed.
r($1j�q_Lr/Ja(�buae(owQWp\a(fs�jmhr �2,-✓.`�71L Date(month,day,year)
�/T sp J' 'rV\S` m7S5 E.•� kAfr e Sr'v--L-lv. C�7� %f1
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
rte(month,day,year)
Address of authorized person (number and street,city,state,and ZIP code) \
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