HomeMy WebLinkAboutMortgage_Foster r STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year
FOR DEDUCTION FROM ASSESSED VALUATION
f Il State Farm 43709(RU/6-09)
I
Prescribed by Department ent of Lo Government Finance
INSTRUCTIONS:
To be filed in Form filed e•
2014
person or by mail with the County Auditor or County Recorder of county where the property is located.
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought `�L unty Auditor
2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months
before March 31 of each year the deduction is sought - Court R
19 See reverse a for additional instructions and qualifications.
Ta;111 th.- ,/ Key ri her/leg. •esaiption / ?/� // Retotd number Page number,\
'1✓_// L>L . .��i 00 ,�� (OOJIl —QG� T LI (f
mortgage/Contact indebtedness unpaid as of Mortgage/Contact indebtedness r paid as of Is the appr:ant the sole
1M'- 1,axraa year // March 1,current year date of aPPhastia�y-/1 \ legal or equitable miner?
// / 6de� ❑ Yes ❑ No
If no,what a his/her exact share of interest? If owned with someone other awn spouse,indicate with wham
If name on record is different than that of applicant.indicate below. , �pproperty in question:Annuafy Assessed
Real Property ❑Annually Assessed
• l�M1l G�W r .4 TTT'"' Montle Home(IC 6-11-7)
Name of mortgagee or contract seller 'l
-,
Address of mortgagee or contract seller(number and street,city,state.aid ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street cal:state.and ZIP code) !�//�//!��/{���� &I /A
Does applicant own property in any other If yes,what county? • What a ng2llsin/ct?//(]j,Lr C,-L1/Hasr thiis deduction been requested on property .
county in Indiana? ❑ No U for anent year?
❑ Yes ❑ Yes ❑ No
COUNTY AUDITOR -
Deduction approved in the amount of
20 20 20 20 _ 7 .I_ _•.•._ �/__ _.. ___.
Signature of County Auditor County ' Fos FEE. k�/ L .
II We certify under the penalty of per)ury that the above and foregoing information is "�' � L ma and
owner I contract buyer of the aforementioned property on date application is filed.
Signature Dormers AB name) I`/ — /AClip
Fie:-'.•ent.•.• 'VV.:: t u a •+•7t.city, -rte,and ZIP code) —...)
t /C)q SCD . St fir{ cr. cRIr l VRA-cv(#- M LI 7 Lo 3cj
Person authorized 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) .