HomeMy WebLinkAboutMortgage_Meyer (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year I
FOR DEDUCTION FROM ASSESSED VALUATION I II
[�;_ State Form 43709 t/t-09)Prescribed e d by Department a(Local Government Pearce 1 �
INSTRUCTIONS: eliM
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. O c F '{
Filing Dates: 1) Real Property:Must rile during the year for which the deduction is sought. I fLJT County Auditor
2) Mobile/Manufactured Homes not assessed as Real Properly Must file during the twelve(12)months
before March 31 of each year the deduction is sought. I ' y.--It +' - •• •ar
See reverse side for additlonal instructions and qualifications. � �r
Applicant(owner or contract buyer-see restrictions on reverse side) GIDCI N COUNTY AUDITOR
T ''�OistQQ G2 o Key X.
/legal descrip. Record number Page number
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Comma Indebtedness unpaid as of Is the applicant the sole
March 1,Mena year March 1.current year data of appfimtion legal or equitable owner?
02.0 a o 6 I ❑ Yes El No
If no,what is his/her exact share of interest? If owned with someone other than spouse,i imte with whom
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
I Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller ,r
mortgagee of tgagee or contract seller(number and street,city, am,and ZIP code)
I
Name of assignee or other owner or holder of mortgage _
�l I a�nee °24�city,state,and 3 �I code)
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Does applicant own property in arty other If yes,what county? - What Taxing District? Id-.3`-(//)o a
county in Indiana?
❑ Yes ❑ No V
COUNTY AUDITOR
Deduction approved in the amount at - i
20 20 �l'YL. X20 20 20 i 20
Signature of ,�F�5� '^ County Date(month,day,year)
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 I contract buyer of the aforementioned property on date application is filed. I
X Slgratiue full name) Data(month,day.year)
110- 93 '2
F ent dress of appfir:ant(number and skeet thy,state,and LP code) I
k....4 .
co 15o 5 6 r t- /6 n v s--y - `11 (9-`f 8--
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-03 i Date(month,day.year)
Address of authorized person (number and street city,state.and ZIP code)
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