HomeMy WebLinkAboutMortgage_Lamar t'"''�. • STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Colin Townsh' r
FOR DEDUCTION FROM ASSESSED VALUATION
.t: State Form 43709(R11/6-09)
Presrnbed by Department of Local Government Finance
File Mark ,
INSTRUCnoNS:
F. "".1. "n
To be filed in person or by marl 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. Co
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months tr. •—ti'^f/1 er
before March 31 of each year the deduction is sought - -
See reverse side for additional instructions and q Lions. GIB'
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Tani Key num legal desaip' 1 Record number Page number..
a(0 -(/a-d7 a3— OD3.a o-vaa 40/d 3.3i 2
Assessed value of real properly as of I Mortgage/Contract indebtedness unpaid as of e/Con•.ma Indebtedness unpaid as of Is the ripp�t the sole
March 1,=rent year I March 1,anent year ate of appfi ation/7� _^ legal or equitable owner?
{/ //�/ti�'// ❑ 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 be ovc Is property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract setter ^
/Address of mortgagee or contract seller(number and street city,state,and LP cod
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city:stare,and ZIP code)
Does applicant own property in any other If yes,what county? • What Taxing District? Has this deduction been requested on property
county in Indiana? El Yes CI No for current year?
❑ Yes ❑ No
COUNTY AUDITOR I
Deduction approved in the amount of
-
20 20 20 Drawer /-��/\/�\J 20
Signature of County Auditor - Drawer NO..( t+".I+ lay year)
I/We certify under the penalty of perjury that the above and for. /"1 7 5 rl sident of Indiana and
owner I contract buyer of the aforementioned property on date a Card NO. .....�111--1//
SlgnaWret,frv . ,nor 1 ay,Year,
/r AtS _ ..
Fun _.. t(n. rand s�beot9 state LP�p _
X " d . ) ,CJ2(//C e 01 ,
Person 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) .