HomeMy WebLinkAboutMortgage_Mann its . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
lz;;; FOR DEDUCTION FROM ASSESSED VALUATION ;
State Fonn 43709(R11/6-09) pT
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Prescobed by Department of Local Government Finance 11 _ •� ;�;
File Mark
INSTRUCTIONS: Form ,,,•I{Ip, A .
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. .2014
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought 9 County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property Must tile during the twelve(12)months ,
before March 31 of each year the deductions sought IF/�'r-j l •-i�RA�1,� •
See reverse side for additional instructions and qualifications. t - a - • • l' I
a Tit AUDITr
Appaant(• • contract buyer,t:: ' . verse sw��a�tt �
wn/YI
T..: .'.. Key number/legal description numbey P
a?G- a- 02-3o 0002• 4s- OA ? 7i/ ? /a
Assessed value teal property as of Mortgage I Contract Indebtedness unpaid as of Mortgage!Contract indebtedness unpaid as of Is the applwnt the sole
March 1:wnent year Mann 1,current year data of aPP�tnn .1 legal or equitable avrtter7
5L dad ❑ Yes ❑ No
If no,what is his I her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of app t,Indicate below. Is ice property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee con seller ,
- � ,/ fit .. :1 .1—
Address of mortgagee or contract seller(number and scree 4 ,state,and ZIP code)
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? I Has this deduction been requested on property
county In Indiana? ❑ Yes ❑ No
COUNTY AUDITOR _,,, 7,
Deduction approved in the amount of:
/4-4q#70 .//
20 20 20 20 ��e't W
Signature of County Ator Canty I _
I/We - i 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
ntract b %of r fir• -me ed property on date application is filed. S .d{� 'J /[j/
�,. .. / / /! /✓ ye` .�! /
it Full resident-t,7 - app (number and pity,stare, P code)
702, 3 - zal�. • ) i�rf�rP.oh, .4/ &'7o 70
Person authorized by duly executed Power of Attorney a IC 6-1.1-1 -0.7 Date(month,day,year)
Address of authorized person (number and street city,state.and ZIP code)