HomeMy WebLinkAboutMortgage_Vinnedge (2) a . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
i : FOR DEDUCTION FROM ASSESSED VALUATION
•
Slate Form 43709(R11 16-09) FILE
-- File Mark
-• Prescribed by Department of Lail Gcwemnrent Finance
INSTRUCTIONS: �f1'A
To be filed in person or by mail with the County Auditor or County Recorder of the county wtl$e 1�1q�propetty is located. F�filed with:
Filing Dates: 1) Real Property Must file during the year for which the deduction is sougfiP County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve 1 nths
before March 31 of each year the deduction is sought ❑ County Recorder
See - ens side for additional instructions and ualifications. DITOINT
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Assessed value Of real property as of Mortgage/Co ebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1,octant year Matti t,our
C_Tf-fO� date of application legal or equitable
/f Yes 0 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(afferent than that of appscanl,indicate belo ( Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
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Name of mortgagee or contract seller /
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Address of mortgagee or contract seller(number and sheep city,state,and ZIP code)
Name of assignee or other owner or hddf
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Address of assignee(number and sneer,. Cc
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Does applicant own property in any other /i C- operty .
county in Indiana?
❑ Yes J N ❑ No
4 /
Deduction approved in the amount of. T v CZ. rC5--
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20 / 20 % 1C. 1 —
CO
I I We certify under the pence/alty o�fY4 vt 1J Y `V! •ia and
owner/contract buyer of the aforen J
..nature owner's +name) /
F resident address of applicant(number a
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Person authorized by duly executed Power of —TX/ /76 "C) >/moo
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Address of authorized person (number and street,city,state,and ZIP code) .