HomeMy WebLinkAboutMortgage_Hardiman (7) t a; . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County_ Year
: FOR DEDUCTION FROM ASSESSED VALUATION Yom/ —
�,• 1 . State Form 43709(RN/6-09)
*ell,
Prescribed by Department of Local Govemmenl Finance
File rk
IHS7RUCT1OHS: SEP 2F3 1'I
M be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. rtn 70
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. • n Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)month� 1a��. �root nty
before March 31 of each year the deduction is sought. - '"W"" 41;Tr;lIt oil corder
See reverse side for'a}d/d 'u(n/all instructions and gquualifintionss. OIBSON CO1IMTY A DI
Applicant(owner or�nja�G W !T/sdI 1aiuCLtnz `
.Ta ' istnct 1 J I Key nu /l description /`• Record nu Pa
��o- a-o9- acre-co ciss-ar p rG
Assessed value of real property as of Mortgage indebtedness unpaid as of Mortgage I Conuact indebtedness unpaid as of leIs gal the apparent the sole
Mach 1,osrmt year ,march 1, �J�
data of application legal or equitable owner?
❑ Yes ❑ No
If no,what is his/her exact share of interest? / K owned with someone other than spouse,indicate with whom
If name on record is different than that of app&ant,indicate below: Is the property in question:Annually Assessed
��.\/�/1���,(tp� /�//0 Real Property ❑Annually Assessed
��`.''�`/"' ` r ' 1-�
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Address of mortgagee or contract seller(number and saee4 city:state,and ZIP code)
Name of assignee or other mar et.
'___
Address of assic HAeD •"iatt l�g e—R- _C
i i -
Does applicant c What Taxing District? Has this deduction been requested on property
county in Indian: for parent year? No
6 ❑ Yes
❑
/ ' / 'AUDITOR
y�
Deduction apprc y 04 I' b av
20 20 20 20 20 20 20
Sgna,' iv; /.ty Auditor County Date(month,day,year)
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
11 owner/contract buyer of the aforementioned property on date application is filed.
nature owne name) A / Date(month,day.year)
revdent address of appican/nt(rylmber and*eel,/(ay:state,and ZIP code)
,So -2 t . 4' Li & •4/c:l10 r ii- CL 1 6,1 /319 c17 41
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,and ZIP code) .