HomeMy WebLinkAboutMortgage_Parker STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township I Year
/ANT°
FOR DEDUCTION FROM ASSESSED VALUATION FILED
\'. �/ State Form 43709(R71/6-09)
\ / Prescribed by Department of Local Government Finance
INSTRUCTIONS:
To be filed in person or by mail. vh.
MAR � $
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. 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. An .- . Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of I.. m:4.77"17;
county w ��
were the property is located during the twelve(12)months before March 31 of ea
I COUNTY AUDITOR
---%)FI r zpYQ Io is sought.
1
See reverse side or a ditional instructions and qualifications.
Applicant(owner yorr�con^t]2ctt�buyer-��seeee restrictions on reverse side)
'1. 11 1 Tl}1
—
Taxing District Key number I legal description ��_I R
_31.IJ{-000 .91e_ Record number Page number
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of If Is the applicant the sole
March 1,anent year ��`�O O March1.cu'current date of application P legal or equitable owner?
i- 11 / on -)/ 0 Yes ❑ No
If TTnoo, cwhat�is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
It name on record is different than that of applicant,indicate below. Is the property in question:Annually Assessed
El Real Property ❑AnnualyO sess d 1.1-7)
Name of mortgagee or contract seller
C crcan krec Can ? o cncp
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
Pt• Svc Moo • �kASpera Jh1 1-4-75q1 - 10,3400
Name of assignee or other owner or holifr 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 yearion been requested on proper.}•
for current year?
county in Indiana? ❑ 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 I contract buyer of the aforementioned property on date application is filed.
Signal e •�.n- ss full name) - Date(month,day,year)
�rsident ad�pplicant(number and street.city.state.and ZIP code) ./?/9y
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)