HomeMy WebLinkAboutMortgage_Trentham .a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County s ear
t.., '_
FOR DEDUCTION)FROM ASSESSED VALUATION
I! State Form 43709(R11/
Prescribed by Department of Local Government Finance �y
Ari 1
INSTRUCTIONS: a'
Form fled with: •
b 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 Property Must file during the year for which the deduction is sought I a un 1/•u• •
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months „w Wbrif i- er
before March 31 of each year the deduction is sought - GIBSO
C• N \ : ■
See reverse side for additional instructions and qualifications. -
App6cant(owner or contract buyer- ..restrictions on rev,' side) r�
�Cj SI_F3L�\)
Taxing District Key number/ -•- _a-ption .r�• /�y� /� Record.nu mb-e3 rr Page number
Assessed value of real property as of -•e/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the appfcent the sole
March 1,current year March 1, t year date of appt�tion legal or equitable owner?
teertiOno (Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than cpv r-e,indicate with whom
If name on record is different than that of applicant,indicate below the property in question:Annuafly Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
tJampaf �or U seller
Address of mortgagee or contract seller(number and street,city stain,and ZIP code) -
1 /+vim
Name of assignee or other owner or holder of mortgage 1 1�O,)�./r•t"
Drawer i;0..•. • • . ....
Address of assignee(number and street,ray.state.and ZIP code) .1
Does applicant own property in any other If yes,what county? -
Card t-CI \O• •••••••• w xi on property
county in Indiana? ^ i_y,,/�
❑ Yes o I - alb"`w-" T .x ❑ No I-
COUNTY AUDITOR
Deduction approved In the amount of.
20 20 20 20 20 20 20
Signally,'of County Auditor • County •Date(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contact buyer of the aforementioned property on date application is filed.
vine's
hail name) Date
7�� Date(month,day,year)
F resid t address of appt�nC t(number and street,oty,state,and ZIP code) •
x26. N. M St. C V/arid Carr• fl), f7&6D
authorized by duly executed Power of y or by IC 6-1.1-12-0.7 Date(month,day,(ear)
Address of authorized person (number and street city,state,and ZIP code) .