HomeMy WebLinkAboutMortgage_Murphy ,F=•-�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count ; cis • I Year I
iii, 4 FOR DEDUCTION FROM ASSESSED VALUATION
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. - State Form 43709(R11/6-09)
''',,tint Prescribed by Department of Local Government Finance
INSTRUCTIONS: 4 ,e( ark'
To be filed in person or by mail. Form filed Veil
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. ,D
Must be filed with the County Auditor or County Recorder of the county where the property is located ,/y( 0 Co Auditor
on or before January 5 of the immediately succeeding calendar year. Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must tile �IG
le with the County Auditor o Rp"oN CO O ,
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought.
See reverse side for additional instructions and qualifications.
Apprytt(owner or ntract buyer-seeret on s reverses- e)
A
Tapp DisHct Key number/legal desuiptio nL to+ s'/1 (1.r(70s Record number pa (: uweti
'YU-^oV1✓ - A,-O -aS-300--tco.cll-oau//Lt_r�14r'c-`� ouam
Accessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1.current year March 1,current year date of aI ca n legal or equ' owns/?ei
+ � 1 Yes ❑ No
If no,what is his/her exact share of interest? It owned with someone older than spouse.indicate with whom
If name on record is different than that of applicant,indicate below Is m roperty in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Na f gages or contract seller
1 —T1A t turd- (titbit
Address of mortgagee or contract sell (number and street.city,stg.a •i Pcode)
_4bl �' df}- i FJ�'7
Name of assignee or other own or holder f gage
Address of assignee(number and street.city,state,and ZIP code)
g a � ��
Does applicant own property in any Omer If yes,what county? What Taxing District. l Has N tletluction been requested on property
county in Indiana? for current year?
❑ Yes ❑ No ❑ Yes ❑ No
•
COUNTY AUDITOR
Deduction approved in the amount of:
20 20_ 20 20_ 20 20_ 20
Signature of County Auditor I County Date(month.day.year)
I/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 t contract buyer of the aforementioned property on date application is filed.
I Sjgn N e(or e(s lull Inamer 1 Date(month/day,ye�1
!‹n 5Aj 3 v y) I
Full ar03 p. b of applicant(number ci staf ,antl 2l c e) ♦ �� 0
erson authorized by duly executed Power of Attorney or by,I,�C'6-11u.11-12-0,7 j1w\ Date(month,day,year)
Address of authorized person (number and street city state,and ZIP code) `p