HomeMy WebLinkAboutMortgage_Mowrer (2) ado STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun [!r ip [�-_jk.,
so nf ; FOR DEDUCTION FROM ASSESSED VALUATION I ,?
._..:;_, . , State Form 43709(R11/6-09)
'1/4• ;2 l prescribed by Department of Local Government Finance
FIPU&rd3 2013
INSTRUCTIONS:
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To be filed in person or by mad with the County dng the year 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 r
2) Mobile Manufactured dHomes not assessed as Real Property Must Me during the twelve(12)months G IBSOpiy,� OF
year the deduction is sought. LJ�
See reverse she for ad nal instructions and qualifications.
Applicant(owner or see on reversede) . _ Ma� i4 t e
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Can:rap In�e�tedness unpaid as of Is the applicant the sole
March 1,arrant year March 1,current year date of app' ti ( / r legal or equitable owner?
C/L"�C�l/ ❑ Yes ❑ No
If no,what is his/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, property in question:Annually Assessed
7C, ear Property ❑Annually Assessed
• 1^ Mobile Home(IC 6-1.1-7)
V
Name of mortgagee or contract seller l
Address of mortgagee or contract seller(number and street,city,state, ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and steel,city,state,and ZIP code) � /��
A Y o.e.e., o -zabr
Does applicant own property in any other If yes,what county? • What Tang District? Has the action requested on property
county in Indiana? ❑ Yes ❑ No for parent year?
❑ Yes ❑ No
COUNTY AUDITOR
Deduction aporaved in the amount cif:
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20 20 20 20
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Signs County-County Date(month,day,year)
I I\ foregoing information is true and correct and that the applicant is a resident of Indiana and
ow e application is filed.
S. Slgnat /' ' ,re' / Date(month,day,year)
I— /' !/rY �� /d s� sb✓�"� ZIP code)
X /ta/ S. %°�
. ut or�d by4exeaaea of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
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i authorized person (nrrmberand street city stare,and ZIP code) .