HomeMy WebLinkAboutMortgage_Pennington (4) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ,1. .i. veer
„ ; FOR DEDUCTION FROM ASSESSED VALUATION
. �. State Form 43709(R11/649) .r 1
Presmbed by Department of Lod Government Finance - - - -- -
File Mark
INSTRUCTIONS: SEP 2 : :-•
.- 'r.,with
To be filed in person or by mad with the County Auditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Property.Must file during the year for which the deduction is sought , A ty Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12) • 11...before March 31 of each year the deduction is sought ���!/ County Reorder
See reverse side for additional instructions and qualifications. GIBSON COU, T” • - 4
Applicant(owner or contract buyer-see restrictions pnreverse side)
7gq in `F rC
amaitzt s?Jn11n,a P/N e y`�^r�r�'C)
D' Key number/Legal description �t Record number/ p e/ 3
�) 2/0-zZ—)LI-3� I lr-of 0Q. cnD/ /`
value of real property as of ;orfga1• /Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the egui rd the sole
1,anent year Marmdhi 7,anent year data of application
legal«equitaole ow+wll
31 (0 COO ❑ Yes ❑ No
If no,what is his/her exact sham of interest? If owned with someone other than warn,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 Ncontract seller
Address of mortgagee or contract seller(number and street city,stab:,and ZIP code)
Name of assignee or other owner or holder of mortgage _/ ^... ..
iococo in Address of assignee(number and street cry,state,and ZIP code) ' ��' `t •�'J O0
Does applicant nwm property in any other If yes,what county? • What Tr Drawer NO...... 1. property
county nn Indiana? ❑ Yes El No .11 ..••.. ❑ No
Card NO ! —y/ 73
COUNTY AUDIT, ..........
Deduction approved in the amount of •
20 20 20 20 20 20 20
Signature of County Auduor County Date(month,day,year)
I 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.
tnabue(ownee '-a . •) Date(mead;day,year)
,/2-7740061120/y
Full read- d- of app v t(Nrtnberand, 4 city,state,and ZIP code)
F by drily executed Power of Money or by IC 61.7-72-0.7 Date(month,day,year)
Address of authorized person (number and street city,state,and ZIP cede)' .