HomeMy WebLinkAboutMortgage_Ricker (2) m , ;• , STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County I Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
trr State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
INSTRUCTIONS:
To be filed in person or by mail. Fo` ileerl1d`"1V' E,h; /
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought. 7 -IT 014
Must be filed with the County Auditor or County Recorder of the county where the property is located LLJJ County Auditor
on or before January 5 of the immediately succeeding calendar year. County cor a
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(12)months before March 37 of each year the COUNTY AUDITOR
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
1 CM.r\. tka Lary B. Rester �_�
Taxing District Key number I legal description " Record nun er Page number
V\ol� irtakA aryl- iZ-loo tbif. °i3K-42 QN w aor /4/(D 9
Assessed va a of real proty as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Ma 1,gwnent year March 1,current year date of applicatio`n/'1 legal or equitable owner?
SI Q \0OO �1r 2`1V � Yes 0 N
If no,what is his I 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 property in question:Annually Assessed
Fl Real Property ❑ Assessed Annually 6-1.7-7)
Name of mortgagee or contract seller
Plevoas &nk dim . Pe oss Mor�ge
Addre of mortgagee or contract seller(number and street.eitjsate,and ZIP code)
2.050 Oar wad Offire Circle, l3,rminyhwn fit. 3q8414 Name of assignee or other owner or older of mortgage
Address of assignee(number and street,city,stat_,and ZI code)
Does applicant own propetry in any other If yes.what county? That Taxing District? Has this deduction been requested on property
for current year? ❑
county in Indiana? ❑ Yes No ❑ Yes No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20_ I 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 property on date application is filed.
/� �,(� D mo N.day,year)
Sign - s (Mam ) �r � ,, .. ///c1
F a dent address of icant(numb r and street.city slate,and ZIP code) ' L����
Sthg -mss w 0w�-,SOALcL T_N
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 I Date(month,day.year)
Address of authorized person (number and street.city,state,and ZIP code)