HomeMy WebLinkAboutMortgage_Weber 4 r. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Colin Township Year FOR DEDUCTION FROM ASSESSED VALUATION till J y !
State Form 43709(R71/6U9)
Prescribed by Department of Local Goverment Finance
File Mark
INSTRUCTIONS: DEC 2 ,F.4, .,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 dining the year for which the deduction is sought. • Co ty Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)coo I -�i•
before March 31 of each year the deduction is sought ' V mA'bi Courrty Recorder
See reverse side for additional instructions and qualifications. GIBBON COU . .
7owner or contract b see restrfclions on reverse side)
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Taxing District ran regal description I Record mbar P e number
o ('. °760-�y ? a3oy - 000 . G9g - oo ) Olga
Assessed value of real property a�^ Mortgage/Contract indebtedness unpaid as of Mortgage/Contact indeb4Mness unpaid as of Is the appEcant the sole
March 1,current year �/ March 1,current year date of appacatim I legal or equitable owner?
1(0OQQ I ❑ Yes El No
tf no,what is his/her exact share of interest? r If owned with someone other than spouse:Indicate with whom
If name on record is different than that of appgpnt,Indicate below. Is the property in question:Annually Assessed
❑Real Property ❑ArmuallyAssessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller C/3
Address of mortgagee or contract seller(number and street city,state,and ZIP code) _ _
Name of assignee or other owner or holder of mortgage
Drawer \ill /�
Address pf assignce(n�ber 4 ray.crate,and L code) . - „/ �S —
Does applicant own property in other 7 If yes,what county?• What Team
Card \O. (1/�I`//'/
openly in Indiana?
❑ es ❑ No _ No
COUNTY AUDITOR
Deduction approved m the amount of
20 20 20 20 20 20 20
Signature f County Auditor. County Date(month,day,year)
l Q�Chf I
I I We certify under the penalty 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 on date application is filed.
X Sigr7(owners fit name)
I Date(month,day,year)
/Fug ' em C-nf enrolment(number and sine& state,and ZIP code) I —
/�\/ ,2 15 /G.u.—oa-i-on.(-l- pa ltlo- ( C.L.9 , n) in 6 h U
Person authorized by duly 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) -