HomeMy WebLinkAboutMortgage_Parker a. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS cop 11 T s Year
FOR DEDUCTION FROM ASSESSED VALUATION Lp
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State Forth 43709(R11/6-09)
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_- Prescribed by Department of Local Government Finance I �y g�v�g
INSTRUCTIONS: DEC to m201
Forth Ned with:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. • WI
2)Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months a=_n►I�j;� Wei
before March 31 of each year the deduction is sought. - G I B i O N CO 'k Y '� i I U K
See reve e ' e for additional instructions and qualifications.
AppGgnt(/� soon Quyer-slee on re ) L/9�/-_//IC�// ,1
Tag /C J, c.T/C%r / al e31C�SltLLX�-,d �ib"T �eL�///L�(•/UDo? 7 20/.3 P o 3 .
Mortgage I C_
Assessed value of //a { Mortgage/Contract indebtedness unpaid as of Mortgage/Contract hMebb�t{�e/-illness unpaid as of Is the applicant t the sole
March 1,current yrdrtrt�/ March 1,current year date of application/�V �� legal or equitable O
Yes
If no,what is his/her exact share of interest? If owned with someone other than spnem j indicate with whom
If name on record is different than that of applicant,indicate below. Is piopeny in question:Annually Assessed
Reel Property ❑Annually Assessed
• _ ^ I Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract setter. /a. �/A / /
Address of mortgagee or contract setter(number and street, state.and ZIP code) ,(n!,_l/L/
Name of assignee or other owner or holder of mortgage - .5i
Address of assignee(number and steel.city,state,and ZIP code) /._• WO , J �v
I
__________I.dues_ county? What Taxing District? Has this deduction been requested on property
�� � K'1 -�y� for current year?
] !7 U /C.( i✓� - I ❑ Yes ❑ No
4ivi4I-0p 5 _ _ COUNTY AUDITOR
/.3—/4O?Li I
20 zo Izo 20
Signature of County Auditor County I Data(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the I
Applicant is a resident of Indiana and
owner/contract buyer of the afore tttppp aaen ed property on date application is filed.
Sgnarei/Viel narni / / I Date(month,day.year)
.l atilpeRpent address of a t(number rd sinter,city,state,and ZIP code)
lam__/ O-, e0.S )q aseM1 (jeer eSicJcf
Person authorized by duty 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,city,state,and ZIP code)