HomeMy WebLinkAboutMortgage_Lankford (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County
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FOR DEDUCTION FROM ASSESSED VALUATION It
-a : State Form 43709(RH/6-09)
x:::a. Prescribed by Department of local Government Finance
Fi- ■ a.
INSTRUCTIONS: r • I
b be filed in person or mad with the Court Auditor or County Recorder of the county where the
Form with:
Pe by ry ry ry property is located.
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought Cou , -
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months i, n
before March 31 of each year the deduction is sought
GIB-0 OUNT OUNT AUDITOR
See reverse side for additional instructions and qualifications.
Appfirant(o}�Peycontact buyer e site
(/�// �/ q� Dot t1 �L/�/// 4/— J/ Record /polo/�
Taxing /�� E i '�L–�C� OlID � C1 / -6.�L/� [�C7!CO 4 1" 3 &( v
C(/ property as of Mortgage/Contract indebtedness unpaid as of Mortgage/ •.ct Indebtedness unpaid as of Is the applicant the sole
Assessed value of
March 1,anent year March 1,current year date of ap• • /y�-� legal or equitable owner?
-it l._-6 0 ❑ Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other Khan spouse,indicate with whom
It name on record's(afferent than that of applicant.indicate below
H the property in question:Annually Assessed
Real Property ❑Annually Assessed
Name of mortgagee or contract seller Mobile Home QC 61.1-7)
Address of mortgagee or contract seller(number� � tea,and .
Name of assignee or other owner or holder of mortgage
Address of assignee(number and sweet,city,state,and ZIP code) •
– —
Does applicant own - -- What Taxing District? Has this deduction been
county in Indiana? for current year? requested on Prop•try
�'� ❑ Yes ❑ No
Drawer NO... �1
YAUDROR
Deduction approver -
Card NO.
20 20 20 20
I
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 contract buyer of the aforementioned property on date application is filed.
4. Sigma• name) Date(month,day,year)
..1... F • t address of number and street,ray,state,and ZIP code)
/r�°�
00E / ., 41–,t.1-p5r- Folr Se n /• '. 11196"r
. -arson 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) .