HomeMy WebLinkAboutMortgage_Maurer (2) STATEMENT OF MORTGAGE OR CON 1�I[ B 1 :I County Township Year
FOR DEDUCTION FROM ASSESSED VAL T C
f: State Form 43709(R11I6-09) Y 1V
Presmbed by Department of Local Government Finance
NOV 14 2013 File Mark
INSTRUCTIONS: Forth Ned with:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the .<•• is located.
F i l i n g Dates: 1) Real Property Must fi l e during the year f o r which the deduction i s -..'id: _! 1; �I County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property M �r,.' ..r111 7, �1 onths LJ-1
before March 31 of each year the deduction is sought COU T County Recorder
GIBBON
See reverse side for additional instructions and qualifications.
Appfiwnt(owner or contract buyer-see restrictions on reverse side )
aLVISA Taxing District Key number I legal descnptmn Record number Page number
Bald- ab-/9-3I-3o I -000. 0250-00 9 QDotf /978'
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Marsh 1,and year March 1,current year date of application legal or equitable owner?
gr, 00 a I ❑ 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 dttetutt than that of applicant,indicate below I Is the prone.^•'ten:Annually Assessed
Annually Assessed
Noble Home(IC 61.1-7)
Name of mortgagee or contract seller .
sr..5 ,Q 641
Address of mortgagee or contract seller(number and steer,city,state,and ZIP code) D j-aW Cr NO•••••• ►•'I
Name of assignee or other owner or holder of mortgage I .1• .••. ••••
Card 1O• .:...... co
Address of assignee(number and street,city,state,and ZIP code) 3 Q icco
Does applicant own property in any other If yes,what county? vvnat Taxing Dsma? Has Nu deduction been requested on property .
county in Indiana? ❑ Yes ❑ No I for wren year? ❑ Yes
n ❑ No
Cn ycr»41 f n? Z6/fay I
COUNTY AUDITOR I •
Deduction approved in the amount of.
20 20 20 20 20 20 20
Signabae of County Auditor • County I Date(month,day.yeah
I I We certify under the penalty of perjury that the above and foregoing information is true and correct and that thejapplicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
SIgnature(ownecs hll name) Date(month,day.year)
Full resident address of t(number and sheet t$state, ZIP
>` //-5-,/%C� C� 4� z- �/03�
Person authorized by duty executed Power of ey or by IC 64.1-12-0.7 I Date(month,day,year)
Address of authorized person (number and street city,state,and ZIP code)