HomeMy WebLinkAboutMortgage_Goedde (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun cash' Year
ciFOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
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INSTRUCTIONS: D
Form filed wii.
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.
Fling Dates: 1) Real Property:Must file during the year for which the deduction is sought r , •u.r Auditor
2) Mobile/Manufactured Homes not assessed as Real Property.Must file during the twelve(12)mg9ti •r• 0 i/ariT,1•t!
before March 31 of each year the deductions sought "raSO �? - Recorder
See reverse side for additional instructions and qualifications. //]] ,///1,(//�,, •
lip• r. on contract bu-k /- m reverse Q' a / ' n O r 0 4VJ
T.:��' l/7/ /igal description ( (� p Record number Page number r�0-n�/}t �P61 (7- d/-k_303• n06. /Viz?- CO / o�d/74 .V77`K
Assessed vane areal property as of Mortgage/Contract indebtedness unpaid as of Mortgage 1 Contact indebtedness unpaid as of Is the applicant the sole
March 1:cvrenttear March 1,current year date of aD legal or equitable owner?
i0// OQ ❑ yes ❑ No
If no,what is his I her exact share of interest? If owned with someone outer than some,indicate with whom
If name on record is different than that of applicant,indicate below Is property in question:Annually Assessed
Real Property ❑Annually Assessed
-
Mobile Home(IC 6-1-1-7)
Name of mortgagee or contract seller
Address of mortgagee or contract seller(number and 4 nary,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) I
Does applicant own property in any other Ili yes,what county? • What Taring District? Has this deduction been requested on property
county in Indiana? for current year?
❑ Yes ❑_No_(/�•� - — ❑ Yes ❑ No
Drawer NO... y-.^�y.••• )UNTY AUDITOR
Daductir vvv
20 Card NO. ' l l 20 20 20 20
Signatim County Date(month,day,year)
I/Wi 7 information is true and correct and that the applicant is a resident of Indiana and
... __..___ ,..a.................• ..r,.r.a..y.� ua,a apy�i.ation is filed. .
Sig -(owner's bm name), )b Date(month,day,)ear)
n '� U C
Ful x dent address of applicant(number and et city:state,and ZIP code
3O 5• (.c) /10 tb 8 Nit s-� f 2(.d. IF `.b b aCo
•-,,• authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,city,stare.and LP code) .