HomeMy WebLinkAboutMortgage_Morehead (2) yti,z. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County F fr hi l 0 FOR DEDUCTION fi-D9)FROM ASSESSED VALUATION
triiState Form 43709(R71/
Prescribed by Department of local Government Finance
File Mark
INSTRUCTIONS: • • • _ t
To be filed in person or mail with the County Auditor or Court Recorder of the county where the property F
Pe by ty County ry P PeM located.
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought Co A d•
2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months b.j
before March 31 of each year the deduction is sought - �'T •�••rt`• •• •er
GIB`• . • . . ar
See reverse side r additional instructions and qualifications.
Applicant( oriOntraa buyer on re e) _/^/ 1-4-8
TA Di Meyn ben/ d ten Record ter Pa enum
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid alifof is the applicant the sole
Mardi 1,current year March 1,current year date of application legal or equitable owner?
/ad,...0-03 ❑ 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 petty in question:Annually Assessed
eal Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller ���
Address of mortgagee or contract seller(number a street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage
c:5- 036 . 3 - // - 0712-90 ,
Address of assignee(number and street,dl%state,and ZIP code)
Does applicant own property in any other I If yes,what county? • I What Taring District? Has this deduction been requested on property
county in Indiana? ❑ for current year?Yes ❑ Yes ❑ No
I Drawer NO.. 0.121
Deduction approved in the amount of:
20 zo Card NO. t ( t g 20 20
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Signature of County Auditor Date(month,day,year)
I
I 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 property on date ap ' lion is filed.
owlets name) Date(month,day,year)
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u t address of applicant number and strae/4p/ry,state,and ZIP code) •
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Person authorized by duly executed Power of Mornay or by(C b .1-12-0.7 Date(month,day,year)
Address of authorized person (number and sheet,city,state,and ZIP code)