HomeMy WebLinkAboutMortgage_McCandless (6) �:r . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County 7 shi Dr
FOR DEDUCTION FROM ASSESSED VALUATION
t i State Fenn 43709(R11/6-09) I
Prescribed by Department of Local Government Finance ,���((ry�,f.,��(
INSTRUCTIONS: IhRi .rZ 2014
Fenn Ned with:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought I MI' •L -...91•1 if•
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)month friliri
before March 31 of each year the deduction is sought months I B S 1'N 1T b
U 44)(j ir'•i R
See reverse side for additional instructions and qualifications.
Ap t(owner or contract huge a reslrirLmc O on reverse side)
II
erg number/ •-I description Record number Page number
PV- - Tu3 ato - to-(O-qf DTI • 60a . n( 1 - o at t4 1ct r.a
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract inclebtedns unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of application legal or
oreguitable owner?
bpbpp ['glees ❑ No
i
If no,what is his/her exact share of interest? tf owned with someone other than spouse,indicate with wham
If name on record is different than that of applicant,indicate below. Isthe property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
NLatof mortgagee or contract seller
0 31f--0
Address of mortgagee or contract seller(number and street,ay,state,and ZIP code) —
Name of assignee or other owner or holder of mortgage Sat) [/'��/��r�1�f'�/,�
Address of assignee(number and street,Sly,state,and 2 I. V1a r.�l L rr'^"
Does applicant own property in any other If'. ��v"""...IWWVo this deduction been requested on property
county in Indiana? ❑ No m l: rent year?
❑ Yes ❑ Yes ❑ No
Deduction approved in the amount of. 1 N " I giA
20 20 20 - - I _.. I 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/•.ntract buyer of the aforem- S property on date application is filed.
Signabae�i fug•: / Date(month,day,year)
r-,-dent address• .. t • mber and sheet,city:state,and /P code)
f tar Ci r SoS , /e.-vvra-,. ,c 44,4?a
-arson authorized by duly ex-•ted Power of Attorney or by 1 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and sheet,city,state,and ZIP code) .