HomeMy WebLinkAboutMortgage_Martin (3) a, . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
ti4FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R11/6-09)
Prescribed by Department of Loral Government Finance
File Ma
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Farm fAt fr:1-2'2013
Filing Dates: 1) Real Property: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(12)months
before March 31 of each year the deduction is sought. Coun e
See reverse side for additional instructions and qualifications. GI3SOIINNNCOUNT _ 0 ._
Apr .r or can buyer-see -*if- on revprse 1
Pi l q 0/oe - �.
T. •4i Key umber/legal description Record number File number
a cl- 7-A57--/0/-.060?. 00 9-oa 7 A4 i /j
Assessed value of real pgop�as 000jjj///JJJ <II Mortgage/Contract indebtedness unpaid as of Mortgage/Contact indebtedness unpaid as of Is the appUnnt the sole
March 1,current year /(f -' March 1,current year date of appGration ^'� legal or equitade aa.+teN
/ 07V/ et) ❑ Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spous<,indicate with whom
If name on record is different than that of applicant,indicate below: Is th property in question:Annually Assessed
Real Property ❑Annually Assessed
. Mobile Hone(IC 6-1.1-7)
Name of mortgagee or contract seller d
i�rnro� • /97-74e
Address of mortgagee or contract seller(n bet and street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage /� //
Address of assignee(number and street,ay,state,and ZIP code) �f `y //� // CP 7 "Zn /j •
Does applicant own property in any other If yes,what county? - V Taxing District? Has this deduction been requested on propertyl.: ,!v'1
county in Indiana? ❑ No lll//l for current year?
❑ Yes ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor I Caunty /''�,— ' l-' ,_,- ,I Date(month,1day,year)
•
I I We certify under the penalty of perjury that the above and foregoing information ii I )' I t c)4„.. 1c'1 m ovv.ki - and
owner I contract buyer of the aforementioned property on date application is filed. Lf v "� TTT 111' "`��� ` ,'
Signs 0;(owners tua na ,:
at Oc)
tent address of applicant(number and steer,city,state ZIP code) I I q e
s81 • l.0- 5,11 \?•1v€ rt nce>.4oY 1
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
Address of authorized person (number and street,city,state,and ZIP code) .