HomeMy WebLinkAboutMortgage_Hurst (10) CONTRACT INDEBTEDNESS
r k FOR FROM ASSESSED VALUATION COUntyF 1 1T+�pmsh Dar
State Form 43709(R11/6-09) tlr I
Presaibed by Department of Lad Government Finance �y
INSTRUCTIONS: '4P G 1
b be filed in person or by mail with the CountyAuditor or County Recorder of the county where the property is located. Form coed with:
Filing Dates: I) Real Property Must Me during the year for which the deduction is sought I o.un•.n
2)Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months ��J ��. �
before March 37 of each year the deduction is sought - GIBSO .�
Ci NTYA • • •
See reverse side . additional instructions and qualifications.
Appeeant(• if b -see -, 7 on - . side) ,
Taxi/ ' • • / - number/ al desaiption Record number Page number
Z ec J/ .. /O / OO/. oa72-oa7 ao1L i & 4 ?-
Assessed vahie of real property as of Mortgage/Contact indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
Math 1,arrest year March 7,cement year date of appGotion T ( legal w equitable owner?
0; d(/a ❑ 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 appbcant.,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 ‘2/
Address of mortgagee or contract seller(nand street, • , •and ZIP code)
Name of assignee or other owner or holder of mortgage VVV //
Address of assignee(number and street my.state,and ZIP code) Awe"
/��
Does applicant own property in any other If yes,what county? • What Taxing District? Has this deduction been requested on property
aunty in Indiana? ❑ Yes ❑ No for current year? ❑ Yes No
i' T
COUNTY AUDITOR ---
Deduction approved In the amount of: ,
--•
_ 1-
20 20 20 20 20- Drall'el N0,•• /-1
Signature of County Auditor County i / ,
Card NO. 41.
I/We certify under the penalty of perjury that the above and foregoing information is true and con .
owner/contract buyer of the aforementioned property on date application is filed. •
`f. SigreaydejaeYSA name)
T FuS resiid d
applicant(number a�jg street 01%state,and ZIP code)
?O S N SW% PrM 1'r•+1‘535v/1 , .l— e' 4-1a
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)