HomeMy WebLinkAboutMortgage_Parke i
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Court Township Year
, FOR DEDUCTION FROM ASSESSED VALUATION I _-
State firm 43709(R11/5-09) y�
Prescribed by Department of Load Gavemmerit Finance F'I L
File Mark
INSTRUCTIONS: ,)
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Forth filed
Fling Dates: 1) Real Property Must file during the year for which the deduction is sotrg�/�1/ •1 I �unty Auditor
2)Mobile/Manufactured Homes not assessed as Real Property Must file liblnitg the tw1e�312)months
before March 31 of each year the deduction is sought. ❑ County Recorder
See reverse side • additional instructions and qualifications. �� •_4 d
7.4i ill /__ .,,, ��/��milt .,,,, � /,AUDITOR
Ta • a y , Key num 1. id7^/� e1,. V V/.9 7 /700 6 I Rew�quinlrt Page 3 _
value of real property as, of Mortgage/Cog(jjpct indebtedness unpaid as of Mortgage/Contract indebtednes unpaid `as of Is Ne ap 33pAranJ t the sole
March 1,anetd year March 1,curn,}t[ bPQ O date of apProation I legal aequitable O
If no,what is his l her enact share of interest? � 1 If awned with someone other than spouse,indicate with whom
If name on record is afferent than that of appfoant,indicate below. Is the property in question:Annually Assessed
Real Property ❑Annually Assessed
a aDI Q� I Mobile Home 6-1.1-7)
Name of mortgagee or contract seller /!/�aJk •r�/n
Address of mortgagee or intact seller(number and street,city,state,and ZIP code)
e of assigns--- .a /1?or holder of mortgage' 1
Address of assi -A I�I\` M 0 A) Ty k I
Does applicant
k E1.1 yA O What Taxing District? Has this:deduction been requested at property
county in India /'I JO ring for current year? ❑ Yes
❑ No
H A U X35 TA DT ST/4 I !AUDITOR
Deduction apt 13ADK._
20_ $ tort! D`o JV 20 Ito 20
1(�ll �l J County Date(nth,day.year)
'� (month,
I I We a 13 - 33a ormadrn is true and correct and that the applicant is a resident of Indiana and
own- I )1s filed.
ar
Person au. •••.:•by duly executed Power of•.• ey or by IC 6-1.1-12-0.7 i1r.te(month,day,year)
Address of authorized person (number and sweet,city,state,and ZIP code)