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HomeMy WebLinkAboutMortgage_Hawkins (2) '-:_ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year `'Y�„` FOR DEDUCTION FROM ASSESSED VALUATION t C State Form 43709(R11/6-09) Presented by Depatbnent of Local Government Finance �l�yygg INSTRUCTIONS: F _JI.,k.. E D To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. '^�wwww��uu�y� 11LL// FITmg Dates: I) Real Property Must file during the year for which the deduction is sought ❑ County Auditor 2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(1 2)months rl-IR.f ���� er before March 31 of each year the deduction is sought JS!)w See reverse side for additional instructions and qualifications. , Appfvcanl(oa�or contract bp'ar-see resGrAyu pt rev�rselsida . .S/ r w'v C• AUDITOR Taxing District '�c`�'I l l D? (©3 ,ceo •33 4-Q,2 8 d�number Page Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contact indebtedness unpaid as of Is the applicant the sole March 1,=veva year Mardi 1,carrenVfea co) data of aPptrcaton legal or equitable owner? S ea ❑ Yes ❑ No If no,what is his/her exact share es of interest? ' If 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 6-1.1-7) Nane�mortgagee , �1 Th Address of mortgagee or contract seer(number and street,city.state,and ZIP code) Name of assignee or other owner or holder of mortgage Address of assignee(number and street,ray,state,and ZIP code) Does applicant own property in any other I If yes.what counno - What Taxing District? Has this deduction been requested on property , county in Ind'ana_2_ — --— for current year? 1:1 Yes ❑ No ' ��..' "l / WyM� NTY AUDITOR Deduction al I L -015-59 20_ V 20 20 20 l Signature oft County Date(month,day,year) 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 Amer/contract buyer of the aforem ntioned erry on date application is filed. Signature(o'( i ne - Date(month,day,year) //////////// //1,/7_0�y Full nisi address of a• -- t( umber and 4 cry,state,and ZIP code) - __•.authored by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year) Address of authorized person (number and street,city,state.and ZIP code)