HomeMy WebLinkAboutMortgage_Dyer (6) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
' ;= FOR DEDUCTION FROM ASSESSED VALUATION
y'"; t" State Form 43709(R71/6-09)
Presaibed by Department of Local Government Finance F LE
INSTRUCTIONS: �rm�ad uirts
To be filed in person or by mad with the CountyAuditor or County Recorder of the county where the property is located. M i U 7 y ygn
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. PL'JN County Auditor
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. , Q Co �. ' v •er
See reverse side for additional instructions and qualifications. '"xi ' ♦l��r
Apr,.. fide• rorco„ t _OCsy^///7m 1�{ 1/ yn �/ �/7 OIB80N COUNTY /�UDITnR
T.// / ,:�]f0 ' oi al/ (�Q J.C/ �./(�C1 , o d Record Page number
13 1 9 3'f
Assessed value of real property as of Monpage/Contract Indebtedness unpaid as of l Mortgage/Con ci indebtedness unpaid as of Is the appinnl the sole
March 1,current year March I.arnent year I sate of aDPI legal or equitable owner?
❑ 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 tqe property in question:Annually Assessed
(Real Property ❑Annually Assessed
r` Mobie Home(IC 6-1.1-7)
Name of mortgagee or contract seller
r:4/1,_J
Address of mortgagee or contract seller(number and street,city:state,and VP code)
• Name of assignee or other owner or holder of mortgage
'S Qa9&) /'<Aa/i13Pf/i1Y/
Address of assignee(number and street city,state,and ZIP code)
Dces applicant own property in any other If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? El Yes ❑ No for anent year? ❑ No
❑ Yes
COUNTY AUDITOR Al tiZ }�{JA) �(`��_ `31ry�/
Deduction approved m the amount of:. .. I �"'•• //]
20 20 20 20 �./J�` 'L E5 /3—Ariti7
County � ' % I4o n( y� ogre-
Signature of County Auditor *rite!: 7 S1
I�vwC- •
.3- 1-13
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that me awe....,.__._ a and
owner I contract buyer of the aforementioned property on date application is filed.
d Signature(owner's tuft name) (--..‘ (month,day,year)
R1- AAc/ n p &. ' ,PA
/ Pun resid t of applicant(nu ber and�t,Sy,state,and ZIP code)..// .
1(40/ a 5-e�YI;naeq 3)-. Pr/no/ion ltd. '/7(07(-) \I
NC
authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year) G
Address of authorized person (number and street,city,state,and LP code)
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