HomeMy WebLinkAboutMortgage_Ralph STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
UFOR DEDUCTION FROM ASSESSED VALUATION
1' State Form 43709(R71/6-09)
" "- Prescribed by Department of Loral Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. •
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought u 1
2)Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months aI �D
before March 31 of each year the deduction is sought - p County•ecorder
See reverse side for additional instructions and qualifications. APR 155 •,2Ot3
AppGnnl(owrerL see re number on reverse side) a �✓
n �nn se/ / Zs.S/
2r Pc�y`�
Taring District Keynumber/ I description e number
�fit/ A - 1 9 - 3 /_3off - 000 .osi_oo 9 GIE ON COUNTY AUDITnR
p.wced vatic of real property as of Mort gage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the apprxant the sole
March 1,arrant year March 1,current year date of application legal or equitable owner?
9AiDo b ❑ Yes El 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 appst 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
Address of nn tgagee or contract seller(number`and' street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage
M of assignee(number and street,city state,and ZIP code)
hr 5W 3 l - 3 - /0 . 34 YY x4 < .
Does applicant own property in any other If yes,what county? What Taring District? Has this deduction been requested on property - ".
county in Indiana? ❑ Yes ❑ No ter current year?
❑ Yes ❑ No
COUNTY AUDIT(
Deduction approved in the amount of:
Drawer NO X13
20 20 20 20 • _
Signs of County Auditor County Card NO. �����j�
I I We certify under the penalty of perjury that the above and foregoing information it ( "I (�..-�S-7 _(J `p And
owner/contract buyer of e aforementioned property on date application is filed. , i
k_ sg .• (. : Ml; .:) - , I Date(monm,aa1:Year)
�.Fa nt ad �i mbar and street, sate,an ZIP q
J -- b( 11511.) sate, 617/93/
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 ' • Date(month,day,year)
Address of authorized person (number and street city,state,and ZIP code) _