HomeMy WebLinkAboutMortgage_Hudnall STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Countg-� I sp, Gear
FOR DEDUCTION FROM ASSESSED VALUATION g�1 (i n�-{
2-'- -' -.;J State Form 45709(R11/6-09)
���:!"'9
Prescribed by Department of Local Government Finance
'
l- -rk
INSTRUCTIONS: .
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Form
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought ,u•s •
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months rl .r.4nAj•,
before March 31 of each year the deduction is sought - GIBSO . C'II NT A Recorder
See reverse side for additional instructions and qualifications.
,
i. 1 /psi —. �/lL— � /I I_ _AIL./
T-: • ! Record number Page number
.:.•slue ot >-rproperty Mortgage/Contra•indebtedness unpaid as or Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March ,current 1f March 1,current year date of application legal or equitable owner?
ern ❑ 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 appacant.indicate below Is property in question:Annually Assessed
Real Property ❑Annually Assessed
- Mobile Home(1C 6-1.1-7)
Name of mortgagee or contract seller a"' '-- Jag-e-,
Address of mortgagee or contract seller(n a •street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street city,state,and ZIP code) ' /
. L Does applicant own property in any other If yes,what county? • What Taxing I Has this bled bee requested m property
county in Indiana? ❑ yes ❑ No vv for current year? ❑ Yes ❑ No
COUNTY AUDITOR
Deduction+•«,w:d in the amount of:
20- 20 20 20 20
Drawer NO... O/ 3
SignaWn • County ' Date(month,day.year)
I,Wi Card NO. .0, regoing information is true and correct and that the applicant is a resident of Indiana and
application is filed. .
Date(month,day.year)
AFull resident address of applicant(number and street city,state,and ZIP code)
A .ASlP- lit) • .1-e.1jl A. op)P.n.4aP- Pr. (4-7 L6 t
Person authorial by duly executed of Altort�ot by IC 6-1.142-0.7 Date(month,day,year)
Address of authorized person (number and street ay,state,and ZIP code) -