HomeMy WebLinkAboutMortgage_Anderson �� . STATEMENT OF MORTGAGE OR CONTRACT INDEBTED t�I�i�`1 Township Year
,S. ` FOR DEDUCTION FROM ASSESSED VALUATION IF
-: State Form 43709(R11/6-09)
Prescribed by Department of Local Government Finance
DEC 1 1 2014 File Mark
INSTRUCTIONS: .
To be filed in person or by mad with the County Auditor or County Recorder of the county where the pm•-. is • ed. Form Ned -
Fdmg Dates: 1) Real Property:Must file during the year for which the deduction is sought , •( fl county Auditor
2)Mobile/Manufactured Homes not assessed as Real Property.Must file du' ffeyyy-- - 'r �� •' n�l•
before March 31 of each year the deduction is sought - "�°I��U • NTY AUD TO El County Recorder
See reverse side for additional instructions and qualifications.
Appfxan owner or contract b sea resrrictiorss on reverse side)
Tan /Distrct description/legal desption Record number Page number
9 a6 -ia -aq - qa0 -voo. 6 A 9-6 A7 / 9 53 a .)-
Assessed value of real as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract Indebtedness unpaid as of Is the applicant the sole
March 1;asrent year March 1,current year date of application legal or equitable owner?
150 /3O- ❑ Yes ❑ No
If no,what is his/her exact share of interest? If owned with srn eon a otter than spouse,indicate with wham
If name on reed is nLfferent than that of applicant,indicate below Is the property in question:Annually Assessed
❑Real Property ❑Ann mllyrAssessed
• Mobile Houle(IC 6-1.1-7)
Name of mortgagee ootract LV - '• c ,`:t0 - P .�.�!�l(,../��n.--rte -- -
Address of mortgagee or contract seller(number and sheet city,state,and LP code)
Name of assignee or other owner or holder of mortgage ��r
Address of assignee(number and street,city,state,and ZIP code) O/ J Tc1 'j
Does applicant own property in any other If yes,what county? • What Taxing Di I I-., —„-]`JL'{a
county in Indiana?
❑ Yes ❑ No
COUNTY AUDROR
Deduction approved in the amount of.
20 20 20 20 20 20 20
Signet of nay County AUdimr, , ` County Date(month,day,year)
I I We certify under thhe/penalty oof�_r
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 a • 'mentioned property on date application is filed.
`/Straw NA 0 Date(month,day,year)
r` A .. / .
taddress of ape(-•t(number- street oaTy,state,and LP z) / ti .7 6 7/.2_0/4/2.€2,i
autlgRed by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(coon h,day,year)
Address of authorized person (number and sheet city,state,and ZIP code)