HomeMy WebLinkAboutMortgage_Carson STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year _
_..:.
—1 FOR DEDUCTION FROM ASSESSED VALUATION
I: Slate Fartn 43709(R11/6-09) IL
Presaibed by Department of Lod Government Finance
File Mark
INSTRUCTIONS:
F.i1' Sit ;r'7 - I •
lb 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 during the year for which the deduction is sought • County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months
before March 31 of each year the deduction is sought - Ill 4'044" 'ar
See reverse s i d e f o r a d d i t i o n a l i n s t r u c t i o n s and q u a l i f i c a t i o n s. GIB' a • - i r e • • • v II II '� buyer-see dirt.. �drpjE_rseske) /y
Ta. �' , . /legal d)l(q�Un�U N Retail number/ Page
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
March 1,anent year March 1,current year date of a�pp.G���1 �yD legal or equitable owner?
OJ°/t ❑ Yes ❑ No
If no,what Is his/her exact sham of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of apogean;indicate be mvf ` Is property in question:Annually Assessed
�[J Real Property ❑Annually Assessed
Mobile Home QC 6-1.1-7)
Name of mortgagee a contract setter
4--t- 44A.Z). 600 ,ieteLV1-4(/
Address of mortgagee or contract seller(number and street,city,state,and LP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) '�/'/,�/`/-'1ND�'�',�/' /(0
Does applicant own property in any other If yes,what county? - What Taxing[Astrid? Has this d�• /O�eh
aunty in Indiana? ❑ Yes ❑ No for current year P
❑ Yes ❑ No
COUNTY AUDITOR
Deduct.,annweeed In the amount at. ,{,
Drawer NO.,,--7 - - 20 20 20 20
Sigm Card NO /.
County Date(month,day,year)
-
I I - - regoing Information is true and correct and that the applicant is a resident of Indiana and
a - application is filed.
Sign _ - - Date(mend,day,year)
. (�pplcJ _
Fu6resident of applicant -mbar and street,obi,state,and ZIP code)
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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)