HomeMy WebLinkAboutMortgage_Anderson (11) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION r�
°�>s "'�, State Form 43709(Rh /6-09) ri
Presented by Deparbnerd of Lod Government Finance k /
File Mark
INSTRUCTIONS: _>•l :7: .,
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought ❑ County Auditor
2)Mobile/Manufactured Homes not acspcved as Real Property.Must Re during the twelve(12)months
before March 31 of each year the deductions sought - 'I�'+ :I?f11ir• -order
See reverse side for additional irstructionsand qua lifications. GIBSO • t � AUDITOR
Applicant or contract buyer-see ra tans on re side)
Taxing DLL iii Key number/legal description Recoil number Pag bumlA`
Zi-L$-e24 - 5`00 - 600. 9 3 - U e-/ �Q/� !��
Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Marts 1; year Mardi 1,amen year data of S apWatattuon�fn vz legal or equitable owner?
If no,what is his/her exact share of interest? If owned with someone odic anspspouse,indicate with whom ❑ Yes ❑ No
Man
If name on record is different than that of applicant.Indicate below^ Is the property in question:Annually Assessed
❑Real Property ❑AnnuallyAssessed
• Mobile Home(IC 6-1.1-7)
Name of mortgagee or contr9u
Mdress of mortgagee or contract seller(num and st reet, code)
ZIP
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 - I 9 f� fm=rent year? ❑ Yes ❑ No
Deduction approved in the amount of. . , �( \c J_ O
20 20 20 _IX�h 1 \-a1�S \ — 20
Sig of CountY Auditor
N ' I County I Date(mortar.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 aforemen i d property on date application is filed. .
Signature/(oven1- t no Date(month,day,year)
F f�tA.•--of:/'-�num r arr1756eet,aTy.state,and ZIP code) " ,/ /����f�
` SSo - GCn 97 (6to7 •
b�n authored by duty executed Power of Attorney or by IC 6.1.1-12-0.7 / Date(month day,year)
Address of authorized person (number and sheet,ay,state,and ZIP code) .