HomeMy WebLinkAboutMortgage_May (2) s.. . STATEMENT OF MORTGAGE OR CONTRACT INDEBTED ;f S�—Tif} ownship Year
FOR DEDUCTION FROM ASSESSED VALUATION 6 iW"
f" State Form 43709(R11/6-09)
srY Prescribed by Department of Loral Government Finance
MAR 1 8 201 File Mark
INSTRUCTIONS:
To be filed in person or by marl with the County Auditor or County Recorder of the county where the prope ' boat-. , Form
Filing Dates: 1) Real Properly:Must file during the year for which the deduction is sought. ri •
�jq/1j►r, ,,0Counry Auditor
2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twely= '�� - •n ..
before March 31 of each year the deduction is sought. G I BSON 0 J N A Di IW County Recorder
See reverse side for additional instructions and qualifications.
Applicant(
Key rwmber�iegal d ` Record number Page number
a ,a-o� ao -oo0.pate a3 o n/ 3 i/ n0
of mortgage/Contract Indebtedness unpaid as of on gage/Contract indebtedness unpaid as of Is the app5nnt the March 1,cement year 1,current of application legal or equitable owner?
'dea0.(A ❑ Yes ❑ No
If no,what is his/her exact sha ----"'someone other than spouse,indicate wide whom
If name an record is different th Is the property in question:Annually Assessed
❑Real Property ❑Amlualy Assessed
ryp�4.µ5 Mobile Home(IC 61.1=7)
Name of mortgagee or canter J 1� .
Address of mortgagee or cunt ^
Name of assignee or other ow (((��� ��1 ���, ��,
Address of assignee(number ��-�"Y
Does applicant atm property o ;District? Has this deduction been requested on property
many in Indiana? C for current yeaR ❑ Yes
❑ No
6 a,
Deduction approved in the a 1
LI�'g` t'JBVI 20 20 20
.32:641Ludno //��,/� Date(month,day, 18-1.3
I I We certify under t ' 18)!l, ^ rue and correct and that the applicant is a resident of Indiana and
owner I contract buy i//7�_��LL
Signed/re(owner's MI nag I k CO Date(month,day,year)
.« a4 7- -hs-
Full resident address of a•
authorized by duf Date(month,day,year) w
Address of authorized person (number ana sneer,u.r. _.___
' '‘..\