HomeMy WebLinkAboutMortgage_Ruesch STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year I
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' err FOR DEDUCTION FROM ASSESSED VALUATION
r 1� State Form 43709(R71/609)
Presaibed by Department of Local Government Finance
INSTRUCTIONS: 'r' ,I
To be fled in person or by mail with the County Auditor or County Recorder of the county where the property t .
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought County Auditor
2) Mobile/Manufactured Homes not aecnesed as Real Property Must file during the twelve(12)montii IAY Y 1 13County Recorder
before March 31 of each year the deduction is sought - IVV��
See reverse side for additional instructions and qualifications. r d/
Appalant(owneror aver user - ., vetse side) i ] �I '(.YJt
ALA_!:1 �' IA_ !� /•` Ri - -' !-1:.._ OUNTY AUDITOR
Taxing District -• number/legal desoiption / Record number P nll)mbg
as 6 D5 -3l -WI-06a ga_o -oati 13 r�/��SS1J
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the aparrant the ori
March 1,extent year March 1I new O date of apPGcation legal or equitable owner?
❑ 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 record is different than that of applicant.indicate below: Is the property in question:Annually Assessed
❑Real Property ❑AnnuafyAssessed
• Mobte Home(IC 6-1.1-7)
Name of mortgagee or contract seller 0 r ^
Address of mortgagee or contract seller(number and street city,stare,and ZIP code)
Name of assignee or other owner or holder of n n -
Address of assignee(number and street city,s y/ I „ r� .�1^
Does applicant own property in any other 1`/1\-IC7l�l J�,([/��tX�/1/-� Has this deduction been requested on property .
county in Indiana? ❑ Yes ❑ ����1 /'_ — for current year? ❑ Yes ❑ No -
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Deduction approved In the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County ' Date(month.day,year)
I/We certify under the penally 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.
'gnann name Date(month,day,year)
en4 ivy treet city,state,and ZIP code)
authorized by duly executed Power of Attorney or by IC 61.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street city,State,and ZIP code) • . -