HomeMy WebLinkAboutMortgage_Zeisler (2) `t eery STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year
aril FOR DEDUCTION FROM ASSESSED VALUATION
.. .. j,. e"..:3, . - State Form 43709(RD/6-09)
"- Prescribed by Department of Lod Government Fuance
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INSTRUCTIONS: Form filed
To be filed in person or by mad with the County Auditor or County Recorder of the county where the property is located. r 'r�''
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. O r �' C6U�1y 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 - 1 ❑ County Recorder
See reverse side for additional instructions and qualifications. "'t/ 477711:
Apprrant(. b u y e r �N t%UU 1TY AUDITOR
ex. 9i Q�CO Sis
Ta ' /y. ' Key nu ben I legal desert ' Record number Page number
ip /aka .46-i/ / mad o- opo- o?VC/ Ocl 9 clni3 5-073
of real property of 'Mortgage/Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the applicant the sole
March 1,cum ant year March 1.current year date pGCgtm ; O legal or equitable made O No
�� /al/ Yes
If no,what is his/her exact share of interest? t owned Wi eone other than spouse,indicate with whom
If name on record is different than that of applicant Indicate below. Is the property in question:Annually Assessed
Real Property ❑Arnuaily Assessed 1.1-7)
Mobile Home(IC Name of mortgagee or contract seller 6(7/7 E/
Address of mortgagee or contract seer and street.city.
state,and ZIP code)
Name of assignee or other or or holder of mortgage
al° Z /6 — —7/ �j�
Y/(/je / 47/79C-
Id
of assignee(number and street city,stale,and ZIP code)
Does applicant own property in any other If yes,what county? • What Taxing District? Has this deduction been requested on property
county in Indiana? ❑ Yes ❑ No for current year? ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of.
20 20 20 20 20 20 20
Signature of County 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
owner .. I� aforementioned property on date application is filed.
/f Date(month,day,year)
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( cJ 'rncatss' i&) el-76)"TLJ -
Person authorized by dSy 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) .