HomeMy WebLinkAboutMortgage_Rendle e STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Co `!JI itil Year
d FOR DEDUCTION FROM ASSESSED VALUATION -I s . :r'
State Form 43709(RD/6-09)
i n Prescribed by Department of Local Government Finance
DEL F3etnalil3
INSTRUCTIONS:
To be filed in person or by mail. Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed with the County Auditor or County Recorder of the county where the properly is loci!
SON N 0 �. 1)1 Auditor
on or before January 5 of the immediately succeeding calendar year. I O� der
2)Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
JOSEPH W.RENDLE
Taxing District Key number I legal description W Record number Page number �1
JOHNSON CIVIL TNSP 26-18-36-200-002.372-024 oc0D L3 C 1 d-r
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1,current year March 1,current year date of application legal or equitable owner?
$ !03111 s 0 Yes ❑ 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. Is the property in question:Annually Assessed
U Real Properly ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
HALLMARK HOME MORTGAGE
Address of mortgagee or contract seller(number and street.city,state,and ZIP code) -
7421 COLDWATER ROAD, FORT WAYNE, INDIANA 46825 gig
Name of assignee or other owner or holder of mortgage R e UL)LG 1 /Josh
Address of assignee(number and street,city,state,and ZIP code) ` /j - I..1' /
Does applicant own property in any other If yes,what county? W lll!ll���
county in Indiana? , I tor current year?
❑ Yes k(No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20_ 20 _ 20 20 20
Signature of County Auditor County Date(month,day,year)
I/We/We certify e penalty of perjury above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the afo boned pro date ... lion is filed.
Signature(owner's MI name) pE / Date(month,day,year)
��/ the
i s ii 1v no13
Full resident address of appl nt(number and street,city,s ate.and ZIP Dods)
9771 S.Water Tower Drive,Haubstadt,Indiana 47639
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,city state,and ZIP code)