HomeMy WebLinkAboutMortgage_Alkire (2) a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION State Form 43709(R11/609)
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Prescribed tDepartment of Local Government Finance
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INSTRUCTIONS: �4
To be filed in person or by mail with the County Auditor or County Recorder of the county where the properly is located. pct GF 1pU TS
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. -0 County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months
before March 31 of each year the deduction is sought - • n nty Recorder
See reverse side for additional instructions and qualifications. COUNTY AU
Applicant(o• rype or contract buyer- ry umber legal al e GIBSON
T Oisific[ Key number/legal destriPfon Record number Page number
.� cci 10 . 1 a - /8— 7,0.3- o"9 _col& a c 3 30.1
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the applicant the sole
March 1,anent year March 1,current year date of application legal or equitable owner?
331879/ ❑ 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's different than that of appllcart.indicate below Is the property hi question:Annually Assessed
❑Real Property ❑Annually Assessed
Motile Hone QC o-1.1-7)
Name of mortgagee or contract seller
Address of mortgagee or contract seller(number and street,city state.and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state.and ZIP code) �/'�f
Does applicant own property in any other If yes,what county? • What Tarn 901 3......
county in Indiana? ❑ Yes ❑ No I D1 :1\1'CC NO••'�/� .o
COUNTY AUDITOR.; Card 1 •
Deduction approved in the amount of. C 11,U \O• •• —
20 20 20 20 zu 20 -i 20
Signature o County Auditor• e County Dale(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.
1( sigma re wners ra ) Q Date(month,day,year)
rj\j F ' nt , of t(number and sheet,�;state,and ZIP.(g/ge) ,1
Person authorized by duty exew:ed oltir E Attorney or by IC 6-t.1-12-0.7 Date(month,day,}ear)
Address of authorized person (number and street,city,state,and ZIP code) .