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HomeMy WebLinkAboutMortgage_Williamson (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS I County Fm, _s n r` FOR DEDUCTION FROM ASSESSED VALUATION f'. State Form 43709(R11/609) Pre,mted by Department of Lod Government Finance ee MM rIp o INSTRUCTIONS: �JULa L o I ' XI be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Forth coed with: Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought Co ,; . ,.• 2)Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months 4 ' dr+►HIr, before March 31 of each year the deductions sought 61:-.0 w 0..“tij,. t a fro- See reverse side for additional instructions and qualifications. Applicant(ptrper ogmntracybuyer see m re rse �� Tax'vhg District fv�JV�'p�,/`} a6 E =3�description Oak ' m { P�`i�VS- Assessed vaiue of red property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the apprant the sole March 1,current year March 1,cement year dar ifipariptiorw legal or equitable owner? ( ❑ Yes ❑ No If no,what is his/her exact share of interest? H owned wiL 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) Name of mortgagee or contract seller /' /1 C Li Address of mortgagee or contract seller(number and street,city,state.and ZIP code) Name of assignee or other owner or holder r v��0� /• C,ri41w " �IT S ' IA - --.. JU C1 o . '"" Address of assignee(number and street,di `% •. Does applicant own property in any other • Drawer 0 1O.""". I /_9 1J Has this deduraon been requested on property . county in Indira? ❑ Yes C Card NO. .......too... f°r° "`�n ❑ Yes ❑ No wUINNT/TYY_AUDITOR . Deduction approved in the anrwm at: 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. Signabxre -me) Date(month,day,year) A.AleMor Full ryvd�t of appl'pnt(rum•i- •�; i• ,state,and LPmde) P/nary\5/w ( � ����W//� � �/r/�, r ��]M,/may` ©� by duty V.i `A Alti4/� or by IC 6-1.1-12-0.7 5 Date(mwGh,day,year) Address of authorized person (number and street city.state,and Li^/P ode) .