HomeMy WebLinkAboutMortgage_Babaian w f:a�. STATEMENT OF MORTGAGE OR CONTRACT INDEBTE u ty Township Year
� . FOR DEDUCTION FROM ASSESSED VALUATION
I State Form 43709(R11/6-09)
Pna«ibed by Department of Loral Government Finance
MAY 21 2014 File Mark
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the ny is located'.I Form filed with
Filing Dates: I) Real Property Must file during the year for which the deduction is sought. �7r 0 County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file dun _the fh31
before March 31 of each year thedeductvnissought- GItlSON COUNTY AUDITOR° County Recorder
See reverse side for additional instructions and qualifications.
•.., t • - or contract buyer-see restricth3ns core/side)
• • 12 0---6 —"d
Ta a istrict / Key number/legal desaipton Record number Page number
ab -A3 - / 4 - ADO - tor 96 .E - bay aol3 / 39a--
vatie of real property as of Mortgage/Contact indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the applicant the sole
Mach 1,wrens year Mardi 1.amentyear date of apprtation legal or equitable owner?
d 3 d 1705 El Yes 0 N
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 F rst F
Name of mortgagee«contw seller y DI.a11CI NO `"`-' ! '
�A-t �(LDxC ,
Address of mortgagee or contract seller(number and street city state,and ZIP code) 1
Card 10. �i1 139°
�
Name of assignee or other owner or holder of mortgage L$ 1
Add f assignee(number and steel,'.state.and ZIP code)
Does applicant own props in any other / If yes,what county? What Taxing District? Has Nis deduction been requested on property
county in Indiana? ❑ No Yes for current year? ❑
Yes ❑ No
COUNTY AUDITOR '
Deduction approved in the amount at
20 20 20 20 20 20 20
Signature of County Auditor ` 6 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 I contract buyer of theee aforementioned property on date application is filed.
XS��ne. na el VAN ` Date(month.daY•YeaO
IPSI O'1� nt address of a tt(number and sheet.city,state,(`and ZIP code)
Persona rid fi executed eP C` oaf or 6y I 6,.,-12-0.7-o4� 1 L� -7 In 39 Date(m«a.day,year)
Address of authorized person (number and street,nly,state,and ZIP cede)