HomeMy WebLinkAboutMortgage_Newton (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cop t Township Year '
Li all*:' FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(RU/6-09)
Prescribed by Departrtont of Local Government Finance /
File Mark
INSTRUCTIONS: I D . A•
To be filed in person or by mail with the County Auditor or County Recorder of the county where the properly is located.
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought I • 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 - I :ir ' n -ecorder
GIB
SON •.
See reverse side for additional instructions and qualifications. 1 . I 0:TOR
•.....• (owner or ntraa b see restrictions on reverse -)
j cLy...Ada.
T.:. . ., . Key number/legal description Record number Page number
?
! m er
. ; _/ 4f- 1 - ' oa - oDO .3BLi -000 Qoi3 6623
Assessed value of real property as of Mortgage I irdebtedrt s unpaid as of Mortgage I Contact indebtedness unpaid as of Is the applicant the sole
Marth 1,anent year Mardi 1.um date of application I legal or equitable owner?
rill ooD ❑ Yes 0 N
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: Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
I Mobile Home(IC 6-1.1-7)
Name of rtxxtgag contrail seller _/ /- _�
rmt
Address of mortgagee or contract seller(number and street,city,state, ZIP code) .
Name of assignee or other owner or holder of mortgage Drawer ; /D 2
Address of assignee(number and street coy.state,and ZIP code) Drawer N O/0���/]�/J�,-{`�J
Does applicant own property in any other If yes,what county? . What Taxing I ;�� t ••1 V.///U )
county in Indiana? ❑ Yes ❑ No Card 1\O: """((t (L \//
0
COUNTY AUDITOR -
Dedumon approved in the amount of
20 20 20 20 20 20--- 20
1
Sigrarm of County Auditor • County Date(wan.day,year)
L
I I We certify under of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property an date application is filed. I
/ Signs (ow ers AS name) Date(month,day,year)
Full residentladdrdress aot 2. (number and M city fa,and ZIP )
-ta a(o'j VVV 100 � �.wo , 2J • <0 &Le3
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street.dry,state,and ZIP code) •