HomeMy WebLinkAboutMortgage_Skidmore Fes . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun T; r ship Year
FOR DEDUCTION FROM ASSESSED VALUATION
- state Form 43709(R11/6-09) fi )r •
Prescribed by Department of Local Government Finance File Mark • #
INSTRUCTIONS: • -Form al. 'y'
b be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. . 9 da
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought • County At
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months
before March 31 of each year the deductions sought - GI: O •I •�� Recorder
See reverse side for additional instructions and qualifica'•ns. • NTy.•i
MWmnt or contract i-see
/re (44 • re e) •�/ t .JC-'j+rj-✓ /L�J 4UO)ToR
neY bTerT/I�1.�C•tion ,�DO/ � G_DO Record number/ P
3-010 moo/ /
Assessed value of nil property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract' ess unpaid as of Is the applicant the sole
March 1;nsmnt year March 1,amens year data of apWoation ////ll legal or equitable owner?
CdO 0 Yes El No
If no,what is his/her exact share of interest? If owned with someone other spouse,indicate with whom
If name on record is di ferent than that of applicant indicate below. Is property in question:Annually Assessed
y[j Real Property ❑Annually Assessed
/'\ Mobile Home(IC 6-1.1-7)
Name of rtwrtgagee or convect seller y�/2 /
Address of mortgagee or contract seller(number andl�l�)stroe4 city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage
C54-1 oS(, a0—O2-9 6r/i/51 ,
Address of assignee(number and steel city,state,and ZIP code)
rat county? What Taxing District? Has on property Kr b MOPES I b ENO/3 D y a O ❑ No for
MAL._y;-) K
COUNTY AUDITOR
Al— 53(0) 20 20 20
20 County Date(month,day,year)
I 1 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 I contract buyer of the aforementioned property on date application is filed.
Xsigratu (owner's hAI name) Fe. .4174, _ Date(month,day,year)
F rest address of appurant(number and s(ree alb,state,and ZIP code)
// ' 2(1.3v9 (oSos .ta to-.i 'Grin.. Vfl c' .
Person authorized by duly executed of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street dry,state,and ZIP code) .