HomeMy WebLinkAboutMortgage_Deffendall (3) <#.ir STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township • Year
et_., FOR DEDUCTION FROM ASSESSED VALUATION
Ste F 63709(R 11 i )
rescribed by Department of Local Government Finance
INSTRUCTIONS: rtl a
T Jicahl t
To be filed in person or by mail. 1�J ih:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed with the County Auditor or County Recorder of the county where the property is Iocetp� 1 5 20 County
on or before January 5 of the immediately succeeding calendar year. �HYY 5 County Recorder •
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 31 of each year he
deduction is sought.
See reverse side for additional instructions and qualifications. GI880 N COUNTY U DiTnR
Ap snt(owner or contract b er-see restrictions on reverse side)
'ca.aseLI L (1- COI 1rtne� 01 . De_ enda/1
Taxing District) Key num I legal description Record number Page number
"O--33-loo-CO3,453--D ? Pi NU! 33-1-10 c?01 1571
Assessed value of real property as of I Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1,current year March 1,current year date offapplica torn legal or equitable owner?
/75)/51 ti&S_ ❑ Yes ❑ No
It 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 property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
I OP Pu tC hAJAAJC/AL •
•
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 allo ❑ 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" -d.
gniture(owners tuff ) / sate(month,day,year)
,5 y r
• .. -'- e ► 1. _� i.ai,A ...■ _all - / .L� : /t k...1-9:_i ilI. 1 4-9-/
Fug resident a;ess of applicant(nu r •r and street,city,f tale,and ZIP code) I
\SIG( lunlaQ I •I • ) Fr lncr- 1 ) 'N I-1707
Person authorized by duly 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)
. t.a . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township :ear
.•: ter.;; FOR DEDUCTION FROM ASSESSED VALUATION
'� State Form 43709(R71/6-09) 1�9®Yptr'- lyr
Presaibed by Department of Lod Government Finance Fit>•Fla#--/ I
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. F 7 9Qn��dd•
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought County dGai�dr
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months I--�
before March 31 of each year the deduction is sought - LJ Court R er
See reverse side for additional instructions and qualifications. GIBS QN C
• OUNTY ALu11 OF
.., owner or contract buyer . . .:. C reverse : e)
.1 ! - _10 r i_ _ A ,_ , t////
Tait d a o ii ' - &-- s m-cos 9 .3- oa 2 G Y /s 9/
Assessed value of real. ... .as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1,cocoa year March 1,current year date of appfca752..... legal El ❑owner?
Yes No
if no,what is his/her exact share of interest? If owned with someone other than<ppuma.,indicate with whom
If name on record is different than that of applicant,indicate below Is perry in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Horn(IC 6-1.1-7)
Name of mortgagee or contract seller ae e Address of mortgagee or contract seller(n a street,city,s 0 ZIP
Name of assignee or oho owner or holder of mortgage
5 4 z a ‘5,5 - /- /o „,1■9-e
Address of assignee(number end street city state,end ZIP code)
Does applicant own property in any other If yes,what county? - What Taxing District? Has hs deduction been requested on property
county in Indiana? ❑ Yes ❑ No for current year?
❑ yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County - - ---"]�) h
I nate(month.day.a.year)
I I We certify under the penalty of perjury that the above and foregoing information is true an "- DA ( "' ' ' 7 L
owner I cot-r of the aforementioned property on date application is filed. CD U2 /y�
...4 Sig . , re to 7�� r / / / Wul.�. 'l7 in
Fte resident
8� 9 of n/mrtr(nnu and et.city, ^ h_J /J 9 A /11-1501 J
'(c'her
Person authorized by duly executed PaWCr of Attorney or by IC 6-1.1-12-0.7
Address of authorized person (number and street,al%state,and ZIP code) .
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