HomeMy WebLinkAboutMortgage_Tooley (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township ' Year
;f FOR DEDUCTION FROM ASSESSED VALUATION y
x State Form 43709(R11/6-09) 1
„:'r=
P
TD
rescribed by Department of Laval Government Finance J I
Fr
File Mark
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the properly is located. F. ��� I
Filing Dates: I) Real Properly Must file during the year for which the deduction is sought. • County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(1 2)months
before March 31 of each year the deduction is sought r� , r! 4 '4* er
rIr
See reverse side for additional instructions qualifications.atioonnis. GI c s ' II " • I ',TOR
iC719 Q6 Ta ' / - ♦ Record number Page number
eA�,��/-I( £ S % p/C�3 #1/ 095�� do./ 33/6
Assessed C j�re property as of Mortgage/Conrad indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the appbant the sole
March 1, March 1,current
year date of apprrationOO legal or equitade ownefl
/ � ❑ 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 below. is
OertY in question:Annually Assessed
eal Property ❑Annually Assessed
Mobile Home tic 6-1.1-7)
Name of mortgagee or contract surer �� .
•Address of mortgagee or contract saner(n and street city,state,and ZIP code)1
Name of assignee or other owner or holder of mortgage / // ^
'/7/a Y/(/.C.) /9a-2 , J,we
Address of assignee(number and street city,state,and ZIP code)
Dees applicant own property in any other If yes,what county? . What Taxing District? Has this deduction been requested on property
county in Indiana? ❑ Yes El No for current year?
❑ Yes ❑ No
TTYAUDROR
Deduction approve I vuLky I O'{_J /N
\
20 SuC
E 20_ 20 20
Signature of Cow /, —. 331 Co County Date(month,day,year)
I/We certify ,afom ation is true and correct and that the applicant is a resident of Indiana and
ownert nit ll contract buyer of the aforementioned property on date application is filed.
�'✓-O^'futl roam /C�rr '�` l 1,4,./0 y{{�' �(Date(month,day,year)and Ful�31address5a pPl�tj4r�� 56A / I/ code)Onk c , // y 71/
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,and ZIP code) .