HomeMy WebLinkAboutMortgage_Hofman Enterprises STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C PTO e�5h p—I Year
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'' �e.� FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R11 I 6-09)
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: A -) .w
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. .
2)Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months / 1, _,_. �
before March 31 of each year the deduction is sought. - GIBSON I • • • - • ._
See reverse side for additional instructions and qualifications.
AP buyer-sea on sae
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Assessed valued real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1,aarent year March 1,anent year data of aPpacetion legal or equitable owned
��� ) p Yes ❑ No
If no,what is his/her exact share of interest? I If owned with someone other than spouse,indicate with wham
If name on record is efferent than that of applicant indicate below'. IL is property in question:Annually Assessed
}�J Real Property ❑Mobile Assessed
�jy/��� //\\ Motile Hortte(IC 6-1.1-7)
Name of mortgagee or contract seller ( I�2. ^-"'
Address of mortgagee or contract seller(number and street,city.state,and ZIP code)
Name of assignee or other owner or holder of mortgage
. XI'Ciali-118.0"—ed c273, 07er a/ a? 2 az'2'
Address of assignee(number and street city,state,and ZIP code)
Does applicant own property in any other If yes,what county? - What Taxing District? Has this dedudi i been requested on property
county in Indiana? El yes ❑ No for current year? ❑ Yes ❑ No
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CZ,rnvjt&cc,s'1 COUNTY AUDITOR
Deduct a I a
Drawer NO
2 20 20 20_ 20_
Signet' Card O. I County Data(month,day,year)
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I/y/y going information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signa (owners fiia ) Date(month,tlay,year)
P�sdRFI
Full reeld t address d appg /(n . et,gtyere/ md7A )'/713f
!!�{ zsd ysOG. Attorney /
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,end ZIP code) .