HomeMy WebLinkAboutMortgage_Cates (2) "Tpa STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
•a ' FOR DEDUCTION FROM ASSESSED VALUATION 1' I LE
/ State Form 43709(R11/6-09)
C / Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: . I •
To be filed in person or by mail. Form filed wi• 7 .-
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed with the County Auditor or County Recorder of the county where the property is located ❑ C. my Audi-.r
i
on or before January 5 of the immediately succeeding calendar year. ❑ 4 1;,,'aiNti'In I'
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the _ _ - _ • - •ITOR
county 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.
Appu nt(o ner or contract bier-see restrictions on reverse side)
Melanie M . CaTifS
Taxing District Key number/legal description r•r-��
in: x•Fi oS)or1 R&cor �7grLI 0r10y
QD,S\ ‘ alp-Os-S?- I?I -boa-0`6C9-01'1 t-10 • 8444 U / 1
Assessed value of r property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the applicant the sole
March 1,arn-eennt year March h 1,current year date of application(� legal or equitable owner?
103506 `�S, 1 l 1 1�1g- 1 -1 GI Yes ❑ 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 different than that of applicant.indicate below: Is the property in question:Annually Assessed
O Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Nye of mortgagee or contract seller •,
Er aye - anN
Address o` f mortgagee w contract er Ojni and shet-a state,and EIP code)
10500 k.1f c0.10,1 pr. -F'Ish€r5, IN i-I600,R-7
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any other If yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑ yes ❑ No ❑ Yes ❑ No
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/contract buyer of the aforementioned property on date application is filed.
rile owners fufi pane) Cokrn Date(month,day.year)
rRYRyRyrYruNVVVVVVresiden a(-address of applicant a plicant(nu r old street,city,state.and ZIP code)
(nC9 \ 0 SR- GC , Yatntcc, IN LI7L(o10
Person authorized by duly executed Power of Attomey or by IC 6-1.1-12-0.7 'Date(month,day,year)
Address of authorized person (number and street,city sate,and ZIP code)