HomeMy WebLinkAboutMortgage_Hutchinson nipSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
'. FOR DEDUCTION FROM ASSESSED VALUATION J gam'
' State Form 43709(R11/6-09) �-•'[
Prescribed by Department of Local Government Finance
File Mark -
INSTRUCTIONS:
To be filed in person or by mail. Fo ' ? + '• I
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. County Auditor
Must be filed with the County Auditor or County Recorder of the county where the property is located
on or before January 5 of the immediately succeeding calendar year. yjrT• II •rder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the _
county where the property is located during the twelve(12)months before March 31 of each year the GIB a I ' I I I R
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
JEFFERY M HUTCHINSON
Taxing District Key number/legal description Record number('1 Page number
CENTER 26-13-28-300-000.196-004 13 ' TJ IB
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1,current year March 1,current year date of application legal or equitable owner?
5103100 105714 105714 0 Yes ❑ No
If no,what is his I 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 the property in question:Annually Assessed
GI Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
AMERICAN MORTGAGE SERVICE COMPANY
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
11503 S[PRINGFIELD PIKE,CINCINNATI OH 45246
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant awn property in any other If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑
Yes o ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
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 aforem-ntioned property on date application is filed.
Signature(own- Ayame) Date(month.day,year)
X ////// )C g-
Fu0 res'.- - dr- s of applicant(number an. .Leer,city,state,and ZIP code)
7965 •ST 300 SOUTH,OAKLAND CITY IN 47660
Person authorized by duly executed Power of Attomey 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)