HomeMy WebLinkAboutMortgage_Perry (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTE S$ pFtY Township Year
Z FOR DEDUCTION FROM ASSESSED VALUATION
f� State Form 43709(R71/609)
Prescribed by Department of Lard Government Firenze
JAN 2 7 21114 File Mark
INSTRUCTIONS:
• Ned with:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the pro•- t is Iota;.. si
Filing Dates: f) Real Popery Must file during the year for which the deduction is sought f , �/rlf17Pr County Auditor
2) Mobile/Manufactured Homes not aecnssed as Real Property Must file during GlBS N C `•t'Y AUDIT County Recorder
before March 31 of each year the deduction is sought - LJ Court R
See reverse side for additional instructions and qualifications.
AppGrant( roc buyer-son reverse side)
T � Key number l description Record Revd number Page number
Tt rum4ca a lo— 3 —/ rte( -300 OO 00743 Ckj t /3 630/
Assessed velue of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the applicant the sole
Mach 1,anent year March 1.anent year data of application legal or equitable owner?
7/ Co 7 D 0 Yes ❑ No
If no.what's 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
,n 'pr�operty in question:Annually Assessed
r
Property ❑Mobile ly (IC 6-1.1-7)
Name of ogee tract s ler ��
Address onnrtgagee or or contract t city,state,and Z \ /^Un ` —
Name of assignee or other owner or holder of mortgage L 1 j(D it C` e-`—(''-1
Address of assignee(number and sheet coy,state,and ZIP code) 13 — I
� �
Does appliant own property in any other If yes,what county? requested on property
county in Indiana? ❑ yes ❑ No }fy I 1 L9, 000/ 1/ ���,�/. ❑ yes ❑ No
Deduction approved in the amount of: 1 n4 - IIw1C( 6 •" -
t;�f(�I ls�
20 20 20 l� CM Mv4 - 20
Signature of County Auditor • ay,year)
I/We certify under the penalty of perjury that the above and forE rsident of Indiana and
owner I contract buyer of the aforementioned property on date a
$Ignature(owners futl name) --I:13-7'11741°
Full resid apparent( mbar and street city,state,and ZIP code)
>` 266, S /0 sb IT p/-}/U Aun r/71 7A/ 4746o
Persona by duly executed Power of Attomey or by IC 61.1-1 n.7 Date(north,day,year)
Address of authorized person (number and street city,state,and ZIP code)