HomeMy WebLinkAboutMortgage_Tingley a . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Court in 1y�ts1;t'iar
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FOR DEDUCTION FROM ASSESSED VALUATION �;�'
. pf.c State Form 43709(R11/6-09)
Prescribed by Department of Lod Government Finance
MS 2014
INSTRUCTIONS: Form Aed :
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. ditor
2)Mobile/Manufactured Homes not assessed as Real Property Must Re during the twelve(12)mont6siBs N it c JN.Ykints,'iB@tid9R
before March 31 of each year the deduction is sought `
See reverse side for additional instructions and qualifications.
Applicant(owner or buyer-see on reverse site)
Ta lKey number/legal description number Page number
Alo -1A -o ? - Yo 3 _ Q,/ 63 a -0 )-.8 o /y / c/o
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contrad indebtedness unpaid as of Is the applicant the sole
March 1.anent year Mardi 1,current year data of application legal or equitable owner?
/0 7, DO 0 ❑ Yes ❑ No
If no,what is his/her exact share of interest? tr 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 61.1-7)
•
Name of mortgagee or contract seller V 7
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 dry,state,and ZIP code) ^._,.,.__.__._
Does applicant own property in any other I If yes,what county? • What Taring District ` /O //
county in Indiana? ❑ Yes ❑ No Drawer NO C//•`/ ('///C�/
COUNTY AUDITOR /�/O
Deduction approved in the amount ob Card 1\1O. GGG
20 20 20_ 20 20
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I I
Signs u - County Date(rmrth,day,year)
I I e 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
gr contract buyer of the aforementioned property on date application is filed.
y Sig bn /utl nerpa Date(month,day,year)
F ent a Qress of ep i (numbe�r and sheet ant,state,and ZIP code) L ,, j—__, l 1/7 f^,l
�gici 1--
Trion{ - Sf- P�1�Wr^� l /(J
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 .Date(month,day,yew)
Address of authorized person (number and street city,state,and ZIP code) .