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HomeMy WebLinkAboutMortgage_Fitch (4) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS 4; County Township Year �„ FOR DEDUCTION FROM ASSESSED VALUATION f l Slate Forth 43709(R11/6O9) e Press-bed by Department of Local Government Finance . File Mark INSTRUCTIONS: F Aad y b be filed in person or by mail with the County Auditor or County Recorder of the county where the property is local Filing Dates: 1) Real Properly.Must file during the year for which the deduction is sought gpl.r 2)Mobile/Manufactured Homes not assessed as Real Property Must Re during the twelve(12)months IR before March 31 of each year the deduction is sought - ❑ County Recorder See reverse side for additional instructions and qualifications. JUL 3 1 2014 Appricant(. contract buyer-see t pare - sid; A T. : g• 4 Ke number/�j I description p R_.Sue `—•.y i•: a number / Ia • (0- 12-)f. a 0O- Coo. !ogleOn GIB . • n.)( • NTY •UDITOR3dO dreal PmPen1'as d Mortgage/Contract indebtedness unpaid as of Mortgage I Cora=indebtedness unrmp as of Is the applicant the sole Manth 1,current year March tri rent W✓ date of application legal or equitable owner? h -Oki ❑ 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 ❑Real Property ❑MAnnually Assessed obile 1.1-7) Name of mortgagee or contract seller ©(1 O Address of mortgagee or contract seller(number and street ray,sb1te,1and ZIP cede) Name of assignee or other owner or holder of mortgage /Jm ` j m4-Cli[fir _ Andress of assignee(number and street my:state,and ZIP code) F.,J ll Does applicant own property in any other If yes,what county? What Taring District? / 1 J dr\LD county in Indiana? ❑ yes ❑ No COUNTY AUDITOR Deduction approved in the amount at 20 20 20 I 20 20_ 20 . 20_ . , . Gig ? It County Date(month,Sy Year) I/We certify under the penalty of ppetjury'the–t the>above and foregoing information is true and correct and that the applicant is a resident of Indiana and Amer/contract of the ennliioonnne d property on date application is filed. Signals owner's na:}e, Date(mood;day,year) RA ' ant of a t umberand sheet aTy,state,and ZIP code) Person authorized by duly executed Power of Anorney or by IC 6-1.1-12-0.7 Date(month day,year) Address of authorized person (number and sweet Sy,state,and ZIP aide) .