HomeMy WebLinkAboutMortgage_Newton STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year / •
°` FOR DEDUCTION FROM ASSESSED VALUATION
.,a„ ' t:, State Form 43709(RU/6-09)
, G.b.
N. „; w
4. prescribed by Department of Local Government Fu ¢e
INSTRUCTIONS: #S ,s; \ I1-Z to- I� \� \ File Mark \
To be Med in person or m u with the Court Auditor or County Recorder of the county where the property Farm Sled with:
P by N ty ty P Party is located.
Filing Dates: 1) Real Pmpe .Must file during the year for which the deduction is sought. ❑ County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must Me during the twelve(12)months
before March 31 of each year the deduction is sought ❑ County Recorder
See verse side for additional instructions and qualifications.
Ap (owners buyer-see rest ti ns on leVertituoilin
T Key number/lega description Record whet' PageO�
w a6 Li .- gro4-000 :711-0a2� ((//pp U/
Assessed value of real property as of /Contract Indebtedness unpaid as of Mortgage/Contract Indebtedness unpaid as of Is the appficont the sole
Muth 1,smart year � gram 4 date of applIcatan legal O es D N
If no,what Is his/her exact share of interest? I '000111{'rj7 -LL[ If owned with someone other than ❑ No
spouse.Indicate with whom
It name on record is different than that of a O
applicant udira/teyhe"lrn,�r. I L� t Is the property in question:Annually Assessed
�+ �-•-k • C� l0 11 O I " 1 lr7 D ❑Real Property ❑ArmuallyAssessed
V
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Address of mortgagee or contract seller(number and sheet,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage
�Address of assignee(number and steel,city,state,and ZIP code) —� 00.4111)
�'tree ePplimnt own property in any other If yes,wit (fir, 'on been requested on property
nty in Indiana? 1!-7 `'W^ �1 . 1�it)❑ Yes ❑ No F� t � � YiW ❑ Yes ❑ No
Deduction approved b the amount of J l' I 6 0514
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/..ntract buyer of the remention property on date application is filed.
- -
1 a Dae(rtron h,day,yea!)•
F .' t address• a *omit* wi street,say,state,and ZIP coifs) - - _.-___ ,.
• authorized by duly executed Pourer of Attorney or by IC 6-1.1-12-0.7 -- . D s(month,day year)
Address of authored person (number and street,city state,and ZIP code)