HomeMy WebLinkAboutMortgage_Young (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count ` TtS Year
ibitli
FOR DEDUCTION FROM ASSESSED VALUATION 1
:::i`- '`f" State Form 43709(R12/6-14) •
\ I Prescribed by Department of Local Government Finance
INSTRUCTIONS: SEte ' 1- I
To be filed in person or by mail. Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is I • IL - • •uditor
located on or before January 5 of the immediately succeeding calendar year. ' ��� ^^•,,er
2) Mobile/Manufactured Homes not assessed as Real Properly:Must file with the CountyAuditor of th$tg$(y1 N C' UIJI f((11K
where the property is located during the twelve(12)months before March 31 of each year the deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see resbictions on reverse side)
a� tAtr tilde ,-�°6 ,�.�� L
Taxing Dis number/legal description Record number Page number
t-i a .3b - III-1% -303 -Oc .. no-7 - oa (0 icl dRyS
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of I Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year p I date of application legal or equitable owner?
nap) (, fl ( Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom 1
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Accessed
bfrxeeeeal Property ❑ Annually Assessed
I Mobile Home(IC 6-1.1-7)
Name• mortgagee or contract seller .
Address of mortgagee or contr.4 seller(number and street,city,state,and ZIP code's
Name of assignee or other owner or holder of mortgage
p.p.L t.....
•
Address of assignee(number and street,city,state,and ZIP code) p r a W e 1. 1.Q•••' ..
Does applicant own property in any If yes,what county? What Taxing Dis 1 d `,,(, ...• t of deduction
other county Card ".• ..... ...
in Indiana? ❑Yes ❑No -
A person is not entitled to this deduction unless the person has a balance on persons mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR .
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor 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
owner I contract buyer of the aforementioned property on date application is filed.
Signet 'nets kill name) (/�7''�� Date(month,day,year)
Full resident address oA�ricant(number a. sleet, ` state, P code)
11/443 c3 l S. U3; as r p FL .43rRsck , T.N. { 7(94R
rson authorized by duly 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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed 510,000.
z1.a\ STATEMENT OF MORTGAGE OR CONTRA <ZEBTEDNESS I County I Township Year
a ;� : FOR DEDUCTION FROM ASSESSED VALU 0
State Ford<3709(R11/6-09)
•-^-- = Prescribed by Depanmen;of Local Government Finance Eij
INSTRUCTIONS: �`•/ File Mark
To be filed in person or by mail. JUL 15 pp/� Form fled with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar y'or for which bM_peduction is sought
Must be filed with the County Auditor or County Reiyc3r er o- county where the property is located ❑ County Auditor
on or before January 5 of the immediately succeedmga e • -! ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Prope •.QQfr S ?I'e -••- Auditor of the
county where the property is located during the two We(12)months •-Tote; .rch 31 of each year the
deduction is sought. Do-
Op
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
514Aw/J P yo uO Si€544P,E. L (/o0,0
Taxing District K nnumbe /' al d d rion Record numb r Pace number
6— )q 1flo3-oon p '1-Oa& aoiii Attu
1
Assessed value of real properly as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Mach 1,anent year March 1,current year date of apnlicatio2,917.°°— legal or equitable owner?
(� Si Yes ❑ No
Ili 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: Is the property in question:Annually Assessed
0 Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Address of mongagee or contract seller(number and street,city state,and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Dees applicant own property in any other If yes,what minty? What taxing District? Has this deduction been recuested on property
county in Indiana? ❑ Yes ❑ No for current year? Yes
❑ ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 1 20 20 20 20 20
Signature of County Auditor 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
owner/contract buyer of the aforementioned property on date application is filed.
(owners full name) / �� Date(rroryh Ca y,year)
Full resident address of app( nt(number . street,city.state,and ZIP code)
Person authorized by duly 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)