HomeMy WebLinkAboutMortgage_Neuman STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
ai' s,: FOR DEDUCTION FROM ASSESSED VALUATION
;P, L' State Form 43709(R11/6.09)
r,�;.�, Prescribed by Department of Local Government Finance
ile 1
INS7RUC77ONS:
To be filed in person or by mad with the County Auditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Properly Must file during the year for which the deduction is sought �C�oun
2)Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months J N /111';ry Audi
before March 31 of each year the deduction is sought - `CWhty Recorder
See reverse side for additional instructions and qualifications. /1, ,,1—
Appficant(owner or contract buyer-see restrictions on re v.w¢q{�e) n JNUot, 41K•A�
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Taxing District 0 e. j/ description Record nytnbw- ��mbgt
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Math 1,anent year March 1,current year date of application legal or equitable owner?
5/6 C 1w ❑ yes 0 N
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 ❑Annually Assessed
-
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract staler
•
Address of mortgagee or contract er(number end sheet,city,state.and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street c%stale,and ZIP code)
Does applicant own property in any other If yes,wha bairn been requested on property
county in Indiana?
3
El Yes ❑ No ❑ Yes ❑ No
Dra���erNO.-••� . .....
.. ....
Deduction approved in the amount of. •Card N . ...�y• .........
20 20 20 -7 C�J t SC& 20
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Signature of County Auditor County Date(month,day,year)
I 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 con ct bu of the aforeme boned property on date application is filed.
Signature(o me) r Date month,day,year)
F 'de ad r a number sheet.aly te,and ZIP ) 6��e���
gob H-�wr r sheet,
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authorized by duly 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) .