HomeMy WebLinkAboutMortgage_Lankford STATEMENT OF MORTGAGE OR CONTRACT IND SS Dv Township Year
FOR DEDUCTION FROM ASSESSED VALUATIO
1:'- State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance MAY 3
2013 Foe Mark
INSTRUCTIONS:
Form filed with:
To be fled in person or by mail with the County Auditor or County Recorder of the county - the pm•-rty is located.
Fling Dates: 1) Real Property.Must file during the year for which the deduction is sough `i . .
lie •unty Auditor
2) Mobile/Manufactured Homes not assessed as Real Property tG .4.14;�': % )moOR County Recorder
before March 31 of each year the deduction is sought. •UNTY
See reverse side for dihonal in and/`quya,lifications.
Apprxant(owner or b s r V Wl ll.it _ a (n ^ _/
ch.Di trict - Key number Ilega •esaiption I,`-/y`/,U l/(`l!'� Remrd nu•lose Page tuber
' .� £ 11 4. • I—
Id- •O— _• •8 . O. •f0OA rc 2
• .:.•valued real property as• =yew/Co ebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applrant the sole
Mardi 1 cares year �SDw'��� date of application legal a equitable ovine/?
I✓0 ❑ Yes ❑ No
If ra,what is his I her exact share of interest? ' If owned with someone other than spouse,indicate with whom
If name on record is ddfenmt than that of apparent,Indicate below: Is the property in question:Annually Assessed
• ❑Real Property ❑Annualy Assessed
Mobie Home(1C 6-1.1-7)
Named mortgagee or contract seller
,t9:>)'—'0
Address of mortgagee or contract seller(number and street,city,sta and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of as •.'-m-t'-ene^.o•+,r.�ro^^n^t
Does applicar Drawer e f- NO.. !,'R...•..••• What Taxing Di strict? Has this deduction been requested on property
county in lndc 11 ��,(1 for current year? yes ❑ No
Card NO. .._,.... [R NAUDITOR
Deduction app
4 75,COO:Cc—is .
20 20 20 20
I I
Signature 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 contract buyer of the aforementioned property on date application is filed.
\(Signaaae(o`�w^n'��ery[s�Jhdl name()/\ /� Date(month,day,year)
rrevtlent addressapppd�F(�Jn� � 1—I ✓end ZIP code l✓ `�� �^ l
`at` J _ivy, I-171, 7d •
Person authorized by duly executed Power of/Money 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) .