HomeMy WebLinkAboutMortgage_Strickland (2) °^n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
0..._ 9 FOR DEDUCTION FROM ASSESSED VALUATION
,. State Form 03709(R11/6-09)
w„ Prescribed by Department of Local Government Finance
INSTRUCTIONS: ire Mark ,...—
be filed in person or by mail I • 'r led;
To tb : :
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction Is sought. i ' er,u • .•.i•'
Must be filed with the County Auditor or County Recorder of the county where the property is located
on or before January 5 of the immediately succeeding calendar year. r' ,�wrn Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the /
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought �n
See reverse side for additional instructions and qualifications. 1Clhee1-
Applicant Zachery K rorcoklan buyer
nil side)
UIBSON COUNTY AUDITOR
Taxing District Key number/legal description Rember Page
Center 26-12-26-100-000.099-004 ��'Y �Q33
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,Curren e 0-65—C date of application legal or equitable owner?
❑ 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 ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee r r contract seller
George F. Hasse rinck
Address of mortgagee or contract seller(number and street,city.state.and ZIP code)
3727 Country Lane,Brownsburg, IN 46112
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?
El yes NO Yes ❑ 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 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.
Sig re � Date(rtonm,day,0/01
10/01/14
Full resident add ' of applicant(number and street city.state,and ZIP code)
Zachery K.Strickland,3529 E.250 S.,Fransisco,IN 47649
Person authorized by duty executed Power of Attorney or by IC 61.1-12-&7 Date(month,day.year)
Address of authorized person (number and street city,state,and ZIP code)