HomeMy WebLinkAboutMortgage_Russler LSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION I
state Form 43709(a11/6-09) //
Presmbed by Department of Local Government Finance p p g '
File Milli('a1
INSTRUCTIONS: 9
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Form u/ 9�
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought ❑ County AueMrf4
2)Mobile/Manufactured Homes not assessed as Real Property.Must file during the twelve(12)months
before March 31 of each year the deduction is sought - 1171_County Recorder
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See reverse side for additional instructions and qualifications. ,' ^ �1 n . -'ry COI r•N!tq,(,4
ApP�n it, 5.or 9L /( Qmreve2 WGtr/z4ei r AUOITQF
T n/ /X cKc ey mer/legal description
-// d/ 0900 O o �1G _ Od/ Record numb" Pag e
P dO/ 5‘ n
Assessed
of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the app&cant the sole
Marts 1:amid year Mardi 1,anent year data of a°pri° / legal a owner?equitable own
c.760 dOO ❑ Yes ❑ No
If no,what is his/her exact share of Interest? If owned with someone other than spouse,indicate with wham
If name on record is different than that of applicant,Indicate below Is the property in question:Annually Assessed
n ❑Real Property ❑Annually Assessed
/ -//y1'L4J Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Address of mortgagee or contract seller(number and street,cdy,state,and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(nrm�6erand atreet city,state,and ZIP code) t a/4J Ci3/—a -- // �•/j�CJ
•
Doe What Taring District? Has this deduction been requested on property
tour (/t f C C 'ER, al t. S fa aurent yeah ❑ Yes ❑ No
���IJJ Wan) l.l"f le- 4 COUNTY AUDITOR
Ded D-p101 l
- I - "I W 20 20 20 20
sigr 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• •perty on date application is filed.
SIg fi>8 name Date(nonN,day,year)
F% 4&of a.,.,--I ( ,• a.:street,ary,state,and ZIP code) '
•erson aut orized by duly executed••.- of Attorney or by IC 6-1.1-12-0.7 Date(north,day,year)
Address of aut onad person (number and saeet,city,state,and ZIP code) .