HomeMy WebLinkAboutMortgage_Donohoo STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun hi
FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
File r
INSTRUCTIONS: Si: -
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To be filed in person or mail with the Court Auditor or County Recorder of the county where the properly
Form Nod
Pe by b ry h P Party located.
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought • •only % Cr 2) Mobile/Manufactured Homes not assessed as Real Properly Must file during the twelve(12)months
C• w lit March 31 of each year the deduction is sought - c IB R '' war ff•-r
OU• tiR
See reverse side for additional instructions and qualifications.
Applicant( or contract buyer-ssee on reverse e)
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d stria KeY I legal desmipt n Record number Page nu 6
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,anent year March 1,current year date of application / ex) legal or equitable owner?
❑ Yes ❑ No
If no,what is //his/her exact share of interest? If owned with someone other than<pa se,indicate with whom
If name on record is different than that of applicant,indicate below. �Ist"1P property in question:Annually Assessed
/ \
Real Property ❑Annually Assessed
• Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
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Address of mortgagee or contract seller(n end sfree; land wile
Name of assignee wother owner wholder of mortgage IZ•19
Address of assignee(number and street,coy,state,and ZiP code)
Does applicant own property in any other If yes,what county? • What Taring District? Has this deduction been requested on property
county in Indiana? ❑ Yes ❑ No for current year ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved In the amount at l'1yy��,'-,/
20 20_ - ii(
rr� 20 20
Signature of Canty Auditor 1-:11\'C 1' - Date(month,day,year)
I/We ce t under the penalty i C.11. �1 O t ,, .. • test and that the applicant is a resident of Indiana and
owner/• ntract buyer of. : •.• ..
`Slgretu : .wrreYs full - ) Date(month,day,year)
- Fug resident address of t ....,amen ary,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) _ _