HomeMy WebLinkAboutMortgage_Dressler STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County F nit
s: icee FOR DEDUCTION FROM ASSESSED VALUATION
•P • �'l State Form 43709(R11/6-0S)
Prescribed by Department of local Government Finance
File Ma
INSTRUCTIONS: 1 I I
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is boated.
Filing Dates: I) Real Property Must file during the year for which the deduction is sought n Gou Al • •••1.
Il
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months l, -writ.
before March31 of each year the deduction is sought.
GI: • . • IUDITO'
See reverse side for additional instructions and qualifications.
err 4 t /f, e number/legal T — `� 1A i ✓U 0E2 (5 -- S VW-0°CT_50--(71 r - O°?5L 46 number i POJ 075/7
of real property as of I Mortgage/Contract indebtedness unpaid as of Mortgage/Contact indebtedness unpaid as of Is the applicant the sole
• :F 1•anent year I March 1,cement year date of application /� legal or equitable owner?
(7? ❑ Yes ❑ No
Ifno.what is his I her exact share of interest? H owned with someone other than spouse,indicate with whom
I
U property in question:Annually Assessed Arnually Assessed
:72013 - 555+ ' I ❑
I Motile Hone(IC fr1.1-7)
/ 151 I 1 O° . °C E Z/Pcode)
i
.ty? • What Taxing District? Has this deduction been requested on property
for cutRn1 year? ❑ Yes El No
I
COUNTY AUDITOR
I
20 20 20 20
—1,-_ _____
Signature of County Auditor County I Date(month,day,year)
II 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 conntract buyer of the aforementioned property on date application is filed.
1 SI`a full add na (month,(month,I Date(month,day.year)
FuII resident mss of applicant(number and street city state,ar;4jZIP fco°d°e) eA/
o9&75 41ss1 /Oat- So,14 Pia Gs1at4T -I n/ 17/7CO9
Person authorized by duly 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) .