HomeMy WebLinkAboutMortgage_Stroud (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year I
FOR DEDUCTION FROM ASSESSED VALUATION
j'� State Form 43709(R11/6-09)
Prescribed by Department of Laval Government Emote
File Mark
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the properly is local 444F,,,Aggq
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. F un tar
2)Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)mon
before March 31 of each year the deduction is sought n ecnrder
See reverse side for additional instructions and qualifir/ccaattions. C / MAY 2 7 2013 �(/��•r-/�
Applicant(owner or /7)ewe/dons C on �D 4_0b-'5 in) 5 L J n r», .✓ w.7 I D/1 L 1d-(/ f 9
Taxing District Key number/legal desaipticn "-11 __-St � �•e number
I vli�r i/�111►r"
b16—l7—o I - QCO 603 J75Qa/ MASON COUNTY • DITOR
property Assessed value of real prop as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract i debtedness unpaid as of Is the applicant the sole
March 1,anent year March 1,anent year date of application legal or equitable owner?
/OA./ a 9 6 ❑ Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on axond is different than that of applicant.indicate below: Is the property in question:Annually Assessed
❑Real Property ❑ArnuallyAssessed
- - Mobde Home(1C 6-1.1-7)
Name of mortgagee or contract surer _ -
`1�3 -
Address of mortgagee or contract seller'— \yyyy`
Name of assignee or other owner or hob S-1 r �J� -
Address of assignee(number and sheet \a V I 3 6 r�
Does applicant own property in arty other t? Has this deduction been requested on property .
county in Indana? ❑ Yes ) for anent year? ❑ Yes -
_ yes ❑ No
- v - - -yNTY AUDITOR
Deduction approved in the amount of. t/ v CC
20 20 20 20 20 20 20
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/contract buyer of the aforementioned property on date application is filed.
f/�yy .'rte- : ^/ Date(month,day,year)
/n' t::. .-- •f t(number and street,oho state,and ZIP code)
•erson authored by duty 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) .