HomeMy WebLinkAboutMortgage_Rausch f STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
"f' FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709
De art t/t of 6-09)
L
Prescribed by Department of Lod Government France
INSTRUCTIONS: P A :
To be filed in person or by mail with the County or County Recorder of the county where the property is located. D E ,n1
Filing Dates: 1) Real Property Must file during the year fru which the deduction is sought. DDISfity 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 Co ty R er
See reverse side for additional instructions and qualifications. GI R Sfl
.•..-I (owner or contract buyer-see on reverse side) N COUNTY AUuIIUFf
Taan. s. ` i noon /legal desaip. Record number Page number
,` • / ./ a& '1,2 - /2- Soo - COOr00 Oa. 7 2-0 /3 (0o33
Assessed value of real ptopa;y of Mortgagge/Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the apprront the sole
March 1,current year March 1, /rtent y�r date of appGCation legal a epuitade ownefl
d ❑ Yes ❑ No
If no.what is he/her exact share of interest? ) If owned with someone other than spouse,indicate with wham
It name on record is different than that of applicant.indicate below. Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
'.as .
Name of mortgagee or contact seller C
•
Address of mortgagee or contract seller(number raand street,city,state,and ZIP code) 6
Name of assignee or other owe or holder of mortgage
Drawer L') (//��/y/ -
Address of assignee(number and street,city.state,and ZIP code) N O •>�•'° .•. —
Card N •'
Does applicant own property in any other If yes,what county? • What Tatting Districts - .•,.•..noon been requested on property
county in Indiana? ❑ No I for current year?
❑ Yes ❑ Yes ❑ No
COUNTY AUDFTOR
Deduction approved in the amount at
20 20 20 20 20 20 20
Signature County Auditor. CZ' County Date(month,day,year)
I/We ce�r rider e-natty of perjury that the above and foregoing information is true and coned and that the applicant is a resident of Indiana and
x '4 `/ d. e aforementioned property on date application is filed.
, ,�%+ Date(month,day,year)
4" t address t(numberand t. ndLP e) y
�S ITci2mt ik- co 2(�7O
Person authorized by duty executed of Attorney or by IC 51.1-12-0.7 \ Date(month,day,year)
Address of authorized person (number and street,OJty.state,and ZIP code) .