HomeMy WebLinkAboutMortgage_Stolz STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
€ 'r FOR DEDUCTION FROM ASSESSED VALUATION
c f'• State Form 43709(RD/6-09)
. Pre cribed by Department of Local Government Finance
INSTRUCTIONS: t D
To be filed in person or by mail with the County Auditor or County Recorder of the county where the m is located Ned
properly
Filing Dates: 1) Real Properly Must file during the year for which the deduction is sought. County Auditor
2) Mobile/Manufactured Homes not assessed as Real Properly:Must file during the twelve(12)months I--I
before March 31 of each year the deduction is sought PR Let 1 Cw'pii'Recorder
See revers- side for additional instructions and qualifications. VV LU(3
Applicant owner or•. tract buyer-see restrictions on re.'use site)-
.4.4A it SS 1 — • 1 is'ITU,
Taxing D' i• - orb 13-35-300-OQO • 98 4-ooco - •n oi37 166
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contact indebtedness unpaid as of is the applicant the sole
March 1,current year March 1,current year atgg4ppnpa._tic) legal or equitable owner?
C`/,l/(�J j`�] ❑ Yes ❑ No
If no,what is his/her exact share of interest? if owned with someone other than cprvrw,indicate with whom
If name on record is different than that of applicant,indicate below Is the property in question:Annually Assessed
❑Real Property ❑AnnualyAssessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller LAdvv.....tidn •
OATALULAILAT1
Address of mortgagee or contract seller(number and stee4 coy 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)
Does applicant own properly in any other If yes,what county? What Taxing District? Has this deduction been requested on property
_cou ' Ana? n.Yes for current year? ❑ Yes
❑ No ❑ No
COUNTY AUDITOR
i-
_ Drawer- No.O,bl3
20 20 20 20
i. Card 1r o. .....-I County Date(month,day,year)
I/We certify under the penalty of perjury that me ew..._.id foregoing information is true and correct and that the applicant is a resident of Indiana and
ovmer/co tract buyer of the aforemention rty on date application is filed. i
cable(o name) Date(nlorldl,day,year)
01,172-00)reode•. ..• _-- -../.• t umbe street ay,state,and ZIP code)
P= • - . by duly executed Power of Attorney or by IC 6-1A-12-0.7 Date(month,day,year)
Address of authorized person (number and street,city,state,and ZIP code)