HomeMy WebLinkAboutMortgage_Hoover STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou ty Fist, �—q�t
FOR DEDUCTION FROM ASSESSED VALUATION L ;�r
n`' f t State Form 43709(R11/rs09)
Prescribed by Department of Local Government Finance
INSTRUCTIONS:
1 F'' Pc29 2013
To be filed in person or mail with the County Auditor or County Recorder of the county where the property form filed with:
pe by ry ry ty p party is located:
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. I RI ' _. ,•
2)Mobile/Manufactured Homes not ascarced as Real Property Must file during the twelve(12)months . It V 0#11 i
before March 31 of each year the deduction is sought - I G BS li y'_ '- i ITO
See reverse side for additional instructions and qualifications.
Applicant • - or con..-buyer-,gee on reverse ' ) Qthjitto
Tad•. '.I• bet/ desci Record number Page number
. (:5-/6" - r00 / 3 59/ 7
• ,.value of real property as of rtgage/Contact indebtedness unpaid as of Mortgage/Contrtcr5ebtedn�as of Is the applicant the sole
Marc,1,arrant year rc,1,current year date of application I legal or equitable owner?
47
❑ Yes ❑ No
If no,what is his/her exact sham of interest? If owned with someone other than riwrcn,indicate with whom
If name on record is different than that of applicant indicate below. R property in question:Annualy Assessed
✓` eal Property ❑AnnuallyAssessed
I Mobile Home(IC 6-1.1-7)
Name of mortgagee or contact seller
3107/7), A al—EL I
Address of mortgagee or contract seller in and street city, ..ZIP cede)
iip
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) `/)/ c:5,- /
Ta�s 19 C i9—� - /ni 775496
Does applicant own property in any other If yes,what county? • What Tadngg District? Has the deeductiot been
requested on property
county in Indiana? 0 Yes ❑ No forj t y ❑ Yes
❑ No
• f
•
COUNTY AUDITOR I ° �yJ 8/i3O^ D 4
Deduction approved in the amount of. ,� CJ_I ����� �Q)LL Yst� 1J - 1
20 20 20 20 ` I�7Ir' 1✓ `-�(
iedyoodi /3587 —
Signat ure of County Auditor • County
54°b c Ai ERiI -
I I We certify under the penalty of perjury that the above and foregoing information is true r
owner/contract buyer of the aforementioned property on date application is filed. ,
1 slfgrhatre(owners hdll name) I Date(month,day,year)
Fup ant address of applicant(number and street a]7;state,and ZIP code) I
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 I Date(month,day,year) .
Address of authorized person (number and street ay,state,and ZIP code)