HomeMy WebLinkAboutMortgage_Yoder r '��'c_�� STATEMENT OF MORTGAGE OR CONTRACT IND �D18ES ,. ' / ty Township Year
FOR DEDUCTION FROM ASSESSED VALUATIO ��-�
State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance JUN 2 6 2113
File Mark
INSTRUCTIONS:
Form fled with:
To be filed in person or by mail with the County Auditor or County Recorder of the county whe lie • •.4yr qh�i;;. -ted.
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. IR1lT OR ❑ County Auditor
2) Mobile/Manufactured Homes not accessed as Real Property Must wows 0,0'D�T( 27 moHNs
before March 31 of each year the deduction is sought ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applmnt(ownerorptracf ricbwtyon reverse sit CAM Taxi. a Key cumber I legal description Record nun Page number
a -�a - e-1-tio i 03 1 39 oac aol 3 105
Assessed vat*of real praper:y as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of f Is the applicant the sole
Marti 1.anent year M ptt t � Y r� AAA."f a..w...;-- legal or equitable etym
l/IJ_ �n ...3 ❑ Yes ❑ No
If no,what is his/her exact share of interest? m
If name on record is Efferent than that of applicant.indicate below (. %It N` -a tr r a:Annually Assessed fik
Annually AsseSSed
•
Name of mortgagee or cpct an, 4 C {�I ,� t
Address of mortgagee or contract seller(number and street city,state,and Z1 �� 1_(V\In r / .
/li'ih1 ll��
Name of assignee or other owner or holder of mortgage r /
•
Address of assignee(number and street.city,state,and ZIP code) ,t�n°./1-g Cl •V
Does applicant own property in any other If yes,what county? 11 1, , \ 1 \Jl quested on property
county in Indiana? ❑ Yes ❑ No
(((��� : Yes ❑ No
i
Deduction approved In the amount of. (.0 5
20 20 20 20
Signature of County Auditor aQ /3 — Year)
I I We pert nder the pe•:''of perjury that the above and foregoi / [� ent of Indiana and
owner'/�J.ct'buyer• aforementioned property on date appli J
pad
iAAS
F-ice'.e • II((nnu�mbeer and street city,state,and ZIP code)
--1 S �_ •. ... ., >\.r�tti+C> d. R.;Alit;
Person audio'.._.•. .Lily executed Power of Attorney or by IC 6-1.1-12-0.7 ear)
_ _
I
Address of authorized person (number and street,city,state,and ZIP code) •