HomeMy WebLinkAboutMortgage_Creek STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Court T Year
f FOR DEDUCTION FROM ASSESSED VALUATION f I L
- •�- State Form 43709(R11/6-09)
Prescribed by Department of Laval Government Finance
File Mark
INSTRUC77ONS: APR , ,:,! r, .
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 Properly.Must file during the year for which the deduction is sought • ■ • duct
2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months ' no
before March 31 of each year the deduction is sought. I ,.J
f fli gi t aunty Recorder
See reverse side for additional instructions and qualifications. GIBSON C - - ' ! e
AppA•wnero�• tact buye7}see r/. siYe) .er
Tar! iO 7 5�`v
Irg ,l, � Vdo_ode ,4 - O 9 Record
� vale d real per'as Mortgage/Contract indebtedness unpaid as of Mortgage/Contract i d, edness unpaid as of Is the applicant the sole
March 1,wren year j/. �!J Mardi 1,cement year date of app/cation/ //0:0 legal or equitable owner?
`�'' L//ten C�J(/ ❑ Yes ❑ No
If no,what is his I her exact sham of interest? If owned with someone other than spouse,indicate with whom
It name on record is different than that of appfican/,indicate bebw: Is property in question:Annually Assessed
Real Property p Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller /7 - / ,/J
Address of mortgagee or contract seller(number and street,city,ststate`,a,�and/vZIP code)
Name of assignee or other owner or holder of mortgage n
Address of assignee(number and street,m1:state,and ZIP code) //� /• / £6 �',2_vG /. (J���U
Does applicant own property in any other If yes,what county?/yam d\ What Taring District? Has this deduction been n requested on property
county in Indiana? wre
❑ Yes ❑ No for n h
yea
❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of _
20 20 20 20 �raweri Nr0
....... 1-�... ..
Signature of County Auditor - Co Card NO 117
.
I I We certify under the penalty of perjury that the above and foregoing informal r ••••••••.•, ma and
`v/['� owner I contract buyer of the aforementioned property on date application S filed. 4) 5l b'00_ V-b .
/ �9n (o 'cep) �V I ._ .
F resident address of app&ant(number and street.city,state,and ZIP code)
gas 4 F TnI N TOO/ 1� y76 7�
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 street,city,state,and ZIP code) --- IN.