HomeMy WebLinkAboutMortgage_Kremer f, ,,3. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Comity ç7_t
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p� FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R11/6-09)
����-u--' Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: I - 1
Form 1:-• • .
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.
Elting Dates: 2) Mobile/ManufacturedeHomesnotassessed as Real Property Must during the twelve(12)months i b .��
before March 31 of each year the deduction is sought. - rp�llr'!T?`
GIB'. o . • . _ a • r
See reverse side for additional instructions and qualifications.
l contract buyer-see restrictions on re )
Ta•"g ill/G/fJ Y o-/% 'J/ /tom/-0 9. 0&) 239 number Page
6,7D C)
cwcced value of real property as of Mort gage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant t the sole
Martin 1,current year March 1,current year date of j.4320 legal or equitable owner?
❑ Yes ❑ No
If no,what is his I her exact share of interest? If owned with someone other than cpw,ss,indicate with whom
If name on record is different than that of applicant.indicate below �sth9 property in question:Annually Assessed
I,rJ Real Property ❑Annually Assessed
/�`��� .( Mobile Fiorlle(IC 6-1.1-7)
Name of mortgagee or contract seller /1 L^L^II
Address of mortgagee or contract seller(n street,city state,and ZI i.d )
Name of assignee or other owner or holder of mortgage
m 7 (Ida- ,p
Address of assignee(number and street,c%state,and ZIP code) l l , /1 Il U! 1 da- 61/ _ r. II
Does applicant own property in any other If yes,what county? What Tax 1 ll I �/ —
county in Indiana? ❑ yes ❑ No
Eck -kc y
COUNTY AUDITOF _
Deduction approved in the amount of. C/1
25;
O
•
20 20 20 _ 20
Signature of County Auditor - County
I/We certify under the penalty of perjury that the above and foregoing information is tru ;C/` �
v 13
owner I contract buyer of the aforementioned property on date application is filed.
wner's(us name, .
A a lAO%al
i Fuf resident address of�awl-ant(nu r jnd street,city te,and ZIP code)
/e0 3 L e,�7.142..y, 4441717 47o 3 9
Person authorized by duly executed Power of Z or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,city state,and ZIP code) . . .. __.