HomeMy WebLinkAboutMortgage_Scott a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Co r�it) • ;_r : Year
FOR DEDUCTION FROM ASSESSED VALUATION I
,.:1:. f= State Form 43709(R11/609) l , 1rr•
f r!. Prescribed by Department of Lod Government Finance
.I I/1113 1
I
2t
NSTRUCTIONS: O C T
b be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Foy filed
with:
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought I , , • N.1 ditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)���ppyt//yyq� "'4�Ir y�rd
before March 31 of each year the deduction is sought - �ltl ION COU• Y •.. ta`iieder
See reverse side for additional instructions and q lfications. 0 /
Ap t owner
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Assessed value of real, property as of Mort gage/Contract indebtedness unpaid as of Mortgage/Contact indebtedness unpaid as of Is the applicant the sole
Matta 1,Meet year March 1,Wrmal year data of application legal or equitable owner?
0 Yes 0 No
If no,what is his!her exact share of interest? If owned with ne other than spouse,Indicate with whom
with I
If name on record is different than that of applicant,indicate below. Is property in question:Annually Assessed
Real Property ❑Annually Assessed
• r 777"'''' Mobile Home(IC 61.1-7)
Name of mortgagee a contract seller
nz ., /-/�p Address of magagce or contrdC2 se0er(n eet,� state.aM ZI code)
Marne of assignee or other owner or holder of mortgage n
Address of assignee(number and street,d4. slate.and ZIP code) AI rte /� ^ /0 J. do I9C3
Does applicant own properly hi any other If yes,what county? • What Taxing DDistrict//1 District? 99(/1 Has this deduction been requested on property
county in Indiana? m
❑ Yes ❑ No for current I year? ❑ Yes
❑ No
Qon .Q� n� COUNTY AUDITOR 5
Katy rJ 20 20 I20 20
UY- 5 County Date(month,day.year)
rove and foregoing information is true and correct and that the Applicant is a resident of Indiana and
her I contract buyer of the aforementioned property on date application is filed.
I
4Sn(� �fy��� Date(month,day,year)
Person authorized by duly executed Power of Ataney or by IC 61.1-12-0.7 Date(month,day,year) -
Address of authorized person (number and street dry,state,and ZIP code)