HomeMy WebLinkAboutMortgage_Jordan, f:+ . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
tFOR DEDUCTION FROM ASSESSED VALUATION
r"• 1" State Forth 43709(R11/6-09)
Prescribed by Department of Loal Government Finance
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INSTRUCTIONS:
Form red 1 2.3 1
To be filed in person or by mail with the CounryAUdd PR 3 or or County Recorder of the county where the property is located. 2�13
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. ❑ County Auditor
2)Mobile/Manufactured Homes not assessed as Real Properly Must file during the twelve(12)months
before March 31 of each year the deduction is sought. ❑ Qgynry Re rd
See reverse side for aadditionaall instructions and qualifications. rIBS ON COUNTY
AUDITOR( y verse &..4.4 Ci.e i a .
y Taatg D rrx Ke /legal Record number
70--36„Roo-0OV 37/-Oa/ a6/ 3 P7l0
2
Assessed - of real property as of Mortgage/Contract indebtedness unpaid as of Mortg e/Contract indebtedness unpaid as of is the applicant the sole
Mach 1,amen year Manic 1,aarent year date yf appr6ationn legal or equitable owner?
3 Yes
If no,what is his I her exact sham of interest? If owned with someone other than spouse,indicate with whom
(-16—? - _ -—_-- _ Is the property in question:Annually Assessed
�- u ❑Real Property ❑Annually Assessed
r� �� J�� ,c27-744 ^ Mobile Home QC 61.1-7)
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(\t' krIC-t._ /ZS ts 1
-L \�'�-`-+-(� LJO-
- icy? What Taxing District? Has this deduction been requested on property
f1` for cement year? ❑ Yes ❑ No
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,Iry` 95----) COUNTY AUDITOR
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\\\TTTIII 111YYY County Date(month,day,year)
foregoing information is true and correct and that the applicant is a resident of Indiana and
_ o I B - I v('' e application is filed.
tic \o/ Date(month,day,year)
�S-C �: I / e Z.ti ti-7 (C) s-
11.7 Date(month,day,'de) .