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HomeMy WebLinkAboutMortgage_Lamar (2) f4,. . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Townshiq�.�I ear l FOR DEDUCTION FROM ASSESSED VALUATION ��—{/II q�y� t' State Form 43709(R11/6-09) Presented by Department of Lad GovernrtcrV Finance File Mark INSTRUCTIONS: - To be filed in person or mail with the County Auditor or County Recorder of the county where the ro F• •• Pe by N ry ty P perry is boated. Filing Dates: 1) Real Property.Must file during the year for which the deduction is sought. A C04 ty ....•/ .,• 2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twewe(12)months Ill .IT.March 31 of each year the deduction is sought .i. ••-<p^'-err.•• •er See reverse side for additional instructions and q . •-Lions. GIB' C - - - Ap..,� ,wrier orcontarl6. . --ee restrirh'on e) A Tari2.-xG'c ?z -/ D7 % 3- ©U3.d o-Oil ' 20%� P3fl2 Assessed value of real properly as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the appkant the sole March 1,current year March 1,current year date of application/)/ legal or equitable owner? j ❑ Yes El No If no,what s 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-. lath property in question:Annually Assessed I]TReal Property ❑ArmuafyAssessed �T Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Address of mortgagee or contract safer(number and s��,,state,and ZIP O Name of assignee or other owner or holder of mortgage Address of assignee(number and saee4 dry,state,and ZIP code) Does applicant own property in any other If yes,what county? . What Taxing District? Has this deduction been requested on property oonnty in Indiana? ❑ Yes ❑ No for current year? ❑ No ❑ Yes . COUNTY AUDITOR Deduction approved In the amount of 20 20 20 ''1`/�,/ 20 Signature of Cocain Auditor Drawer NO.!•t^"•� •••••• lay,year) I I We certify under the penalty of perjury that the above and for. h 5 9 mident of Indiana and owner/contract buyer of the aforementioned property on date a Card N O• •••• 111��� �{ Slgreture��; rte . ) / 9Y.Yr�4 P //_ 4. -_sams �( Full >�• -• t(n•m• r and�jjcity,stab +Z,IP�p _ l� r or .T J _i_iarzzi er OLD•\ , wrr,_.4T!/,1_/ L(,ri 7 1C40 , O Person authorized 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,end ZIP code) .