HomeMy WebLinkAboutMortgage_Hillard (2) tale* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7 r• _.a te
f . •,. 1 FOR DEDUCTION FROM ASSESSED VALUATION o!� Er
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State Form 43709(R11/6-09) nano;
•�",s; 1 Prescribed by Department of Local Government Finance
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INSTRUCTIONS: MA
To be filed in person or by mail. Form filed with:
Filing Dates: 1)Real Properly:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed with the County Auditor or County Recorder of the county where the properly is located ,: •i"y4�.'b . -- 'r
on or before January 5 of the immediately succeeding calendar year. a Recorder
2)Mobile/Manufactured Homes not assessed as Real Properly:Must file with the County Auditor QIMPON CO a •7Y • a • .
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.
App (owner or contract Mryar-sye reatricdsnson anise side)
Margaret J Rexing
N-�•�%f/f10-
Taxing Olsokt Key number I legal description Record number Page number
Union 26.18-19-400.001.832-025/PT NE SE 153-11 13- lip
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Assessed value of real property as of =rail I Contract indebtedness unpaid as of Mortgage I Contract Indebtedness unpaid as of Is the appiznt the sole
March 1,and year Mamlt 1,ammt yw date of application legal or equitable owner?
182516.00 ❑ 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 N question:Annualy Assessed
ri Real Property ❑telly Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seder
Fifth Third
Address of mortgagee or contract seder(number and street city,slate,and ZIP code)
5001 Kingsley Dr MD 1MOCBQ Cincinnati,OH 45227
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street dry.state,and ZIP coda)
Does appecant awn property In any other If yes,what county? What Taxing C mated on property
county in Indiana?
❑ Yes ril No Yes ❑ No
COUNTY AUDITOR "
Deduction approved b the amount of: U'
- ►.L • \A
20 20 20 20_ +,� • 20
Signature of County Auditor County I
I/We certify under the penal of perjury that the above and foregoing information is two and correct and that the applicant is a resident of Indiana and
owner/ tract buyer of th= fo.....- ed property on date application is filed.
s natu ra ruff na . _ Date(month,day,year)•
i 03/18/73
FW ant teas• ( ,_r. stare.and ZIP code)
5765 S. • • - "Ile,IN 476
Person authorized by duly executed Power of Aeon y or by IC&1.142 43 Date(month,deg year) {�
Address of authorized person (number and sheet cigt state,and ZIP code) \``