HomeMy WebLinkAboutMortgage_Saulmon (2) STATEMENT OF MORTGAGE OR CONTRACT I T BBJEtJEESj unty Township Year
u f FOR DEDUCTION FROM ASSESSED VALUATI I`- g J
State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
APR 2'2''2013 File Mark
INSTRUCTIONS:
To be filed in person or mail with the Court Auditor or County Recorder of the county - the r' .+:ed. Form filed with:
e by b ty h 1 p:ve '.I
Filing Dates: 1) Real Properly:Must file during the year for which the deduction A�isu sto�udeg ��r111 jar County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property Citktb'1 44%. i 1 -• - YT
before March 31 of each year the deduction is sought. (i I tl5 County Recorder
See reverse side for a '• nal instructions and qualifications.
Applicant(owner can r-se wKerrse le
Ole 1
I g �Key number/ al tlesrn-Plmn Recant number Pape number
o G-ripti n �-3a� ?loin �f 97-007 /`� /y
Assessed vale of real property Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unp of Is the applicant the sole
Marlin 1,anent year March 1,anent yq5 O 00 date of application legal ore equitable❑owner?
If no,what is his/her exact share of interest? `J•j / -1/J,If owned with someone other than spouse,Indicate wI h whom
If name on record is different than that of applicant.indicate below: Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller S/3
Address of mortgagee or contract seller(number and street city state.and ZIP code)
Name of assignee or other owner or holder of mortgage
Drawer r_.r-r^w.cmin.nrd ZiP_code)
L a w C 1 ((\O c7OI lj ✓ that county? Nbat Taring District? Has this deduction been requested on property
for current year.
❑ Yes ❑ No
Card NO. 1610
COUNTY AUDITOR
435/MD • (lb
20 I 211_ I Le 20 20 20 20
•
Signature of idr h J i% o b(1 County Date(month,day,year)
I/ e 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/..:tract buyer o e aforementioned property on date application is filed.
(o -r fig ) Lon Date(month,day,year)
41 4
tin — -nt of t(number and street.aiy,state,and ZIP code)
WO. CO • C0/elM /3
Person authorized by duly 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) .