HomeMy WebLinkAboutMortgage_Wright (4) all STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Year
-- FOR DEDUCTION FROM ASSESSED VALUATION
t'"' 1 State Form 43709(RI1/6-09)
Prescribed by Department of Local Government Fiance
APR File M.
INSTRUCTIONS: APR i+-'1:' :
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. .•. Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must Me during the twetve(12)months 7 �/
before March 31 of each year the deduction is sought. 1.. ' i3 �•'••un(a gg�rd
See reverse side for additional instructions and qualifications. GIBSON Co -
•UDII UK of
Appf�agl(owner-see restrictions verse side) � s
Taxing District CKey cumber I legal esonption /�i Record number Page number
aj - i I - l7 - Liao -Oo4 - 159 - oi / 2,010 9b61
Assessed valued property Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current March 1,current year date of application legal or equitable owner?
/ 2 51 00 0 ❑ Yes ❑ 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 applicant indicate below: Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Holz(IC 6-1.1-7)
Name of mortgagee or contract seller /�
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage /j
Address of assignee(number and cq'.spare,- d code)I 3. c-117 A
oDoesaapgzant own property in any Foter If yes, /what t county? What Taxing District? Has this deduction been requested on property
county m Indiana? for current year?
❑ Yes ❑ No ❑ Yes ❑ No
COUNTY AUDITOR it t3576 SoT(313
Deduction approved in the amount at (�
-- 20 20 20 20 a tl! O
Dralecr NO
Signature of County Auditor( /L1,, ` • County
a LC/^`? ' ,✓! J Card NO. q'Wi,2 t
I/We certify under the penalty of perjury that the above and foregoing information is true e
•
owner/contract buyer of the aforementioned property on date application is filed.
Signature(owner's hal mina) f///1 Date(month,day,year)
Fululresident address of a pfran nom street�:ffite,and ZIP code)
/i / 9 c ec 5 � b�2
/yI-/�lauthorzed by duly executed Power of Attorney or by IC 6-1.1-12-0.7 / Date(moot,day,year)
/v3Eress'd authorized person (number and street,city:stale,and ZIP code) 1N^\'
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