HomeMy WebLinkAboutMortgage_Dupps (3) �,_,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Court , �;rm';n3�? -r
i FOR DEDUCTION FROM ASSESSED VALUATION i um, s le'
'Val)" State Form 43709(R11/6-09)
<—.--s— Presaibed by Department of Local Government Finance AF&la 201
INSTRUCTIONS:
To .be filed in person or by mail with the County Auditor or County Recorder of the county F
where the property is located. ,j Bled -
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. ° • email• ditty
2)Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)monGBS•N *a 1,17V p��
before March 31 of each year the deduction is sought. - 'CoUm➢TCC�r
See revers, side for additional instructions and qua' tions. //
Act.. .. owner�i -L tiJ r 7� �/.!J !4 0���/2712 'J
Ta .•- I4 �/ Id - 1 �C / num 7937z,
(� • o- / / ,U/ lJ v. foci- D 2 0- .{. Abn la/Contma'ugebtedness unpaid as of ortgage/Contract'umn�ddd¢¢¢ppbtttedness paid as of Is the app6ont the sole March 1,arrest / March 1,art te of appGotion/ /I Iegal w equiHde o
( COD ❑ Yes ❑ No
If no,what is his!her exact share of interest? If owned with someone other this—awe,indicate with whom
It name on record is different than that of applicant.indicate below: \Is property in question:Annually Assessed
Real Property ❑Annually Assessed
�, Mobie Home(IC 61.1-7)
Name of mortgagee or contract sailer QleaP Addre ss of mortgagee or contract seller( t, . stat ZIP code)
)
Name of assignee or other owner or holder of mortgage &[ La l..2 // / �.1
Address of assignee(number and street,city:state,and ZIP code) `L
Does applicant own property in any other If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for anent year?
❑ Yes ❑ No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of
20 20 20 20 - _ l )
Drawer NO ���IVVVI
Signature of County Auditor • 1 /
Card NO. I `i S Z
I/We certify under the penalty of perjury that the above and foregoing infortr •) Q"""•••••• rdiana and
owner I contract buyer of the aforementioned property on date application is' 9 2 q. L I
•SFuI resident add of a t number a t,city,state.and ZIP code)
/`J( ' %C s c IN O,4&((erd Ca-f{ - 4f7CoOd
( Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
.. _. /
._ __
Address of authorized person (number and SUM* slate,and ZIP code)
Ad
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