HomeMy WebLinkAboutMortgage_Hancock (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cotinty Township Year
ii:.:M1 FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R71/6-09of) ,
Prescibed by Department I Government Finance
INSTRUCTIONS: I ,,MMrR1q F .
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is locatK C . ./((
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought I FL JN County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months
before March 31 of each year the deduction is sought Recorder
e . �
See reverse side for additional instructions and qualifications. CIBSON COUNTY AUDITOR
Applicant(aw rryr contact buyer-see ferns on l .
numbe�/legal desolation Record numbers Page number
�_ ,aS) acs -let- 3(— Ab3'b6a . 5-ia - oo4 I a0I 4101
1,a
value year property as of Mortgage ge I Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
date of application legal oJ
369 r ` I Lhl 'esO 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 different than that of applicant.indicate below ifs Property in question:Annually Assessed
eel Property ❑Annually Assessed
111111 I Mobile Houle(IC 6-1.1-7)
Name of morsigt...x... ;.oniractseller ,
Address of mortgagee contract seller(number and street city,state.and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street city,state,and ZIP code) _______.------E---
Does applicant own property in any other If yes,what county? - What Taxing Dish* .. _
ir _
county in Indiana?
❑ yes eNo
COUNTY AUDITOR 1 �71)
Deduction approved in the amount at /� O 1 /'� _ l/�'
20 20 20 20 20_ I(//7/�t_ C—T1
Signature of County Auditor County
24_09 Y
I/We certify under the penalty of perjury that the above and foregoing information is true and con Le
owner/contract buyer of th99aforementioned property on date application is filed.
Signature rg rue rrempn /}/
Sig //�\//\\LL1J1J p•�/y 1"I',Ard,cr_ 35115�"�ct 205
Full resident address of applicant(number and street cry,state,and ZIP code) (t5gz5Qnj3.cpm
te2tcg s.MA tos% NAu s7ap7- I,i. 47b34 ipirni
authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 *MOM If
Address of authorized person (number and street city.stare.and ZIP code)
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