HomeMy WebLinkAboutMortgage_Church _ . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS I County Township I Year
CT
. s FOR DEDUCTION FROM ASSESSED VALUATION ��
State Form 43709(R11/DEDUCTION
by Department of lo Government Finance
e
INS7RUC7IONS:
Folio fled _
lb be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. /i Ui ry
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought �`
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months t''�
before March 31 of each year the deduction is sought - �,f'),C unty Recorder
See reverse side far additional instructions and qualifications. 01f�
Aapbm o� b �{BttS sen side) �y IFISON COuN t Y AUDITO}i
Tab 4 Key T .wane ter Page numbs
odx X -off- 300 - 0Oa. 593--Qd V 2ii 3 j_3 o/
value of real property as of •rtgage I Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the applicant the sole
1,amen year March 1,ascent year date of appffea 1 ^ r?
legal or equitable owner?
((,�.�y// / El legal ❑ No
If no,what is his/her end 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. rrIss-,�--ttrh��ee property in quesdon:Annually Assessed
�L,Lr<eel Property ❑Annually Assessed
/X_
Mobile Home(IC 6.1.1-7)
Name at mortgagee or contract seller •
Address of mortgagee or contract seller(number and street.city(i e,and ZIP code)
Name of assignee or other owner or holder of mortgage ( /�
Address of assignee(number and street,dry,stem.and ZIP code) / ` / /a� //�///f Lcs Cil
Dees applicant own property in any other If yes,what county?��-•-/1 What Taxing District? this deduction been requested C/./rnn property .
county in Indiana? ❑ Yes ❑ No current year? ❑ Yes ❑ No
- rnIINry AUDITOR
Deduction app �y .
Dra)ui i- NO a/✓
20 . / 20 20 20
Sigrewreo(C
Card NO. ...5—f�t /�/�/` / County Date(month,day.year)
I I We car rmation is true and correct and that the applicant is a resident of Indiana and
is filed.
hit nanre Dam(mouth,day.year)
� �'r-X ent address of applicant(number and street,city,state,and ZIP code)
1. 1o439 ?)EASAt.IT 'goi-J /-/AURSTA17( il ) 4%39
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 meet city,state,and ZIP code) . - _ _ __ _—