HomeMy WebLinkAboutMortgage_Hering �, _ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4 474:/... FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
FF1 q D
INSTRUCTIONS: Elk,/
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Form Aed
Filing Dates: 1) Real Property.Must file during the year for which the deduction is sought. eR 4$tjW&or
2)Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months ❑
before March 31 of each year the deduction is sought. County Recorder
See reverse side for additional instructions and qualifications.
Auer'ant(owner or contract buyer-see resuidions on reverse side) A;charet A. Her(n� and nritli SSA ID,G11165ONSOUNTY AUDITOR
T strict*/�-'1�G''� / //��Key number/legal desaiptioonn//� ,'�7y/ RRecoccordrrd_number Pag be
Assessed�vahre of real �6f '/MortgagContract irdebtednessun id as of Mortgage l Contract indebtedness unpaid of Is f the applicant/97/
March 1,current year March 1,current year date of application legal or equitable owner?
I G.C.. S00- ,A) /Z Z,coo• too ® 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 properly in question:Annually Assessed
®Real Properly ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or canes}seller
(.,1eskfr. 44e:al Cr-ext. Lucien
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) /:
145cc Au;a+icn (3ivd . Nr,;'3+horne l .A gc),-- .50
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any other If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year? ❑ Yes ❑ No
❑ Yes In No
COUNTY AUDITOR
Deduction approved in the amount of
Drawer NO c2)
20 20 20 20 20 :�
Signature of County Auditor 'County �C.a Cdr 1_�1`O. p I
I/We certify under the penalty of pegury r - e above and foregoing information is true and c ,ate T Q
owne /contract buyer of th•• - • -me Q4'. ..-rty on date application is filed. O ,
Sig .i#R! terrier Date(month,day,year) -
•/074---2 n n.man/number:M strge4 r�Y.sYdfe• tl x code) r ^ 7‘70
Person authorized by duty executed'• -r of Aaa,•-y 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)