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HomeMy WebLinkAboutMortgage_Carpenter STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County _ Township Year Aiktott FOR DEDUCTION FROM ASSESSED VALUATION - State Form 43709(R11/6-09) ' IX •.. 1. Prescribed by Department of Local Government Finance INSTRUCTIONS: To be fled in person or by mail. CFLy, tt Y. 11.LU71 14 Filing Dates: I) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. r`.. County Auditor Must be filed with the County Auditor or County Recorder of the county where the property is located on or before January 5 of the immediately succeeding calendar year. ❑ o coder 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(72)months before March 31 of each year the IBSON COUNTY AUDITOR deduction is sought. See reverse side for additional instructions and qualifications. Appli pt(owner or acct buyer 7s stridions on verse side) 1��i Zt rte Qr r axing District Key nu tier/legal description R nu r P g � �i cif o�1 3/16 e(� -n/D-�o� CX� cX� 6/7 � , Assessed value of property as of 1 Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole March 1,cement year I March 1,ainent year date of application legal or equitable owner? ❑ Yes © No If w11at is his I her exacts f interest? n If owned with omeone other n s use,indicate th whom JO}n-I-Tencin- / t5 01- 5urvi va(3h1 p vuu_i 0 IC ,CQrp r If name on record is different than th of applicant,indicate below-. Is the property in question:Annually Accosted Real Property ❑Annually Assessed Mobie Home(IC 6-1.1-7) Name of mortgagee or contract seller BADK72utr r�')04NeLFL. CORP Address of mortgagee or contract seller(number and street,city state,and ZIP code) Name of assignee or other owner or holder of mortgage Address of assignee(number and street city,state,and ZIP code) Does applicant own property in any other If yes,what county? What Taxing District? Has this deduction been requested on property county in Indiana? for current year? ❑ yes ❑ 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 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/contract buyer of the aforementioned af�oreme�ntioned property on date application is filed. Signs (owner's I// ', Date(month,day,year) 4 Full res address of applicant(number am . ,state,and ZIP code) I 1/(_/ 1tl 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)