HomeMy WebLinkAboutMortgage_Ruiz (2) STATEMENT OF MORTGAGE OR CONTRAENIEITElkSD County Township Year
r FOR DEDUCTION FROM ASSESSED VALUATION OCT
-:Jr .t1 State Form 43709(R11/609) C9
Prescribed by Department of local Government Fiance 1 J 2 013
File Mark
INSTRUCTIONS:
Form filed with:
To be filed in person or by mail with the County Auditor or County Recorder of the p filed arty is located.
Filing Dates: 1) Real Property:Must file during the year for which the de cm UNTy d''��r/�p County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property Must Me during the" ke'5Wmonths
before March 31 of each year the deduction is sought
County Recorder
See a for.,,itional instructions and ifcations.
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' r r I(ey nun /legat�ersrnpmb— M^ 7� . ' Record. mbar Page number. ,
Ira A s s e s s e d value otreal. .. f Mortgage/Con Indebtedness unpaid as of Mortgage I .indebtedness unpaid as of is the app�nt the sole
March 1,current year Mach 1,cu date of appfiration legal or equitable owner?
9 000 ❑ Yes ❑ No
If no what is his/her exact share of interest? f If owned with someone other than spouse,indicate with whom
_
If nan —_"r>rent than that of applicant,indicate below. Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
N-71-"D rawer i\'O �Q/3 -- QJ �1� .iii.
Ad •• ••• • ate,and ZIP code)
Card )\'o. /� ....
I Mora .._. d
Does applicant own property in any other that county? • What Taxing District? Has this deduction been requested on property
county in Indiana? ❑ Yes ❑ No or current year? ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved In the amount of.
20 20 20 20 20 20 20
1
Signature of ••4 •r ' / County Date(month.day.ye/rj'I 0 /7 113
I 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/contract buyer of the aforementioned property on date application is filed.
Signature owners hr9 name)/ Date(month,day,year)and
Person1 authorized ed�oy of
executedd�Pv�wer /Munn street: or C 6-7.1 Z-0 Q nd 0-I ) •-'t i 4 / Da&O .day,Yeah
Address of authorized person (number and street city,state,and ZIP code) J