HomeMy WebLinkAboutMortgage_Satterfield (2) 1 g�
STATEMENT OF MORTGAGE OR CONTRA IN TEf4ES¢ l- County Township Year
s' 'lair,' FOR DEDUCTION FROM ASSESSED VAL TI A /
State Form 43709(R71/6-09)
Prescribed by Department of Local Government Finance OCT 0 9 2013 File Mark
INSTRUCTIONS:
To be filed in person or mail with the County Auditor or County Recorder of the Form N�
pe by ry ry whe is located.
Fifing Dates: f) Real Property Must file during the year for which the deduction i County Auditor
2) Mobile/Manufactured Homes not assessed as Real Profeffe,SeNt GewistritnceittiCisilegynonths
before March 31 of each year the deduction is sought ❑ County Recorder
See reverse side for additional instructions and qualifications.
APPGCanE py buyer- on reverse e) '7 • /
Ta istrbt !�F^�Y` Key nun al desmp� o f_�O ���� Recartf /n Pag nwpgej�
JO.u� .kx•, ► Leap-aar n 3
Assessed value of real pnlpeny as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,anal year March 1,current year date of appacalbn legal or equitable owner?
❑ Yes ❑ No
If no,what Is his/her exact share of interest? tf owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the property in question:Mnuafy Assessed
❑Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-T)
Name of mortgagee contract seller ���s//��� �VJ�-'�y/'/� v
Address of mortgagee or contract seller(number and street city.sate,and ZIP code) /
Name of assignee or other meter or holder of nortgage
Address of assignee(number and street city,state,and VP-'
Does applicant own property in any / O\ t Ta xing it Tang District? Has this deduction been requested on property
county in Indiana? for anent years
❑ Yes ❑ No
�•ct �O yJ
10 t 1R
Deduction approved in the at. .•CI
20 2 C' 20 20 20 20
/ C—
'.na:41P. ,: :.-ter
....
• n D County (�
f`�llr•1C Date mo. ,/�1;_ ��
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
Amer I contract buyer of the aforementioned property on date application is filed.
re(owner's name) Date(month,day,year)
A
Full rpdent applican umber and street,city,state,and ZIP code)
co oo ofs-ituA- c ccifIreAmn , N 01 cfl b
Person authorized by duly executed Power of Attorney or by IC 61.1-12-03 Date(month,day,year)
Address of authorized person (number and street city,state,and ZIP code)