HomeMy WebLinkAboutMortgage_Hopster STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C t>l L L Year
kaciFOR DEDUCTION FROM ASSESSED VALUATION
t State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: JU , . 11-'
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 Properly:Must file during the year for which the deduction is sought II ii. •
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months ' -119701:.
before March 31 of each year the deduction is sought -
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tionalinssttruuctiiionss alnd qualifications.
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4Ta . Di el - Key bet/legal d lion Recd numb"ern Page nu mber
1-19X) - /r�-07 --&CC- (Y° OQ/- &e r ao/7 /707A
value of real property as of Mortgage/Conbaa indebtedness unpaid as of Mortgage/Conaaa indebtedness unpaid as of Is the appeont the sale 9 March 1,aarent year Marti ,wrrent year date of appfraa/oP/� legal or equitable wnerr
�6 ❑ Yes ❑ No
If no,what is his I her exact share of interest? If owned with someone other thaM1 spouse,Indicate with whom
If name on record is different than that of app&anl Indicate below Is property in question:Annually Assessed
eal Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
•
Name of mortgagee or contract seller
Address of mortgagee or contract seller(number nd street city state.and ZIP code)
Name of assignee or other owner or holder of mortgage ///111
Address of assignee(number and street ow,,state,and ZIP code) / ' / / ,r, / a/i/ .957,9-e
Does applicant own property in any other ' If yes,what county? - What TatnngrDstrtr t??•/�{�' '/(Has this deduction been requested on property .
county in Indiana? 0 Yes ❑ No for anent year? ❑ Yes ❑ No
• COUNTY AUDITOR -
Deduclon approved in the amount of: ..
20_ 2/// 20 20 20
Signature of Count) Drawer N O I •
•:••••••• County Date(month,day,year)
I/We certify ul • / • iY mmation is true and correct and that the applicant is a resident of Indiana and
uwner/contra(
Card NO. . !!! 4! is filed.
Date(rngrW,dal:year)
FWLresident address sT,.-.v..u^:moer and Etait city,state,and ZIP code)
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Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.� Date(month,day,year)
Address of authorized person (number and sheet,city,stare,and ZIP code) .