HomeMy WebLinkAboutMortgage_Ricketts (4) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun lir''y��,I � '
: FOR DEDUCTION FROM ASSESSED VALUATION ' ., ,r �.'
-t 7� State Form 43709(R1116-09) �
Presmbed by Deperbnent of Lod Government Finance
File'= ' 2014
INSTRUCTIONS:
To be filed in person or by mail with the County uditor or County Recorder of the county where the properly ffted
h h h P party is bcat�d) :
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought. 8 SON C YA u t -
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 ` strAfy/gg�Pop
See reverse side for additional instructions and qualifications.
Applicant(or+tac m buyer-sea rest on re
Tap District �Q Key nu /legal desolation R rd number Page number
VIV:rY. a tt. • Zlo— la -0—i - 303— looa . o ( k — o. u of°// / 15q
Assessed value of real property as of Mortgage r Connect indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the app5rant the sole
March 1,as-rent year Ma 1,assent year date of application legal or equitable owner?
El Yes ❑ No
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 M the property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee grGntract seller
Address of mortgagee or contract r(number and street coy,state.and ZIP code) — -
Name of assignee or other owner or holder of mortgage _
D)-a welt N &O.•
Address of assignee(number and street,city,state,and ZIP code) ••' r
county applicant d property in any other If yes,what county? • Card �i r /.Q }'t,....• ested on property
❑ Yes ❑ No �' '' •• (/„/S (I`/ .1 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 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/co tr.• buyer of the aforep �ned property on date application is filed.
t�j{��� !r ) Date(month,day,year)
.� l
Full rest.-nt address of appfran ( rand a tits, ta, ���pa)
-1 kfa, to. M.\\'Derr. Yrince}orv. &N 147(.9 70
Person authorized by duly executed Power of Attorney o�by 6-1.1-12-0.7 Date(month,day,)ear)
Address of authorized person (number and street city,state,and ZIP code)