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HomeMy WebLinkAboutMortgage_Sandusky STATEMENT OF MORTGAGE OR CONTRACT INDEB jai Township Year f : FOR DEDUCTION FROM ASSESSED VALUATION i T 11))� " : State Form 43709(R11/6-09) G o v e rn m e n t• DEC 2 2014 File Mark INSTRUCTIONS: To be •filed in person or by mail with the Coun yAuditor or County Recorder of the county where th- , .pe/ty'- Form iced w'tt` Filing Dates: 1) Real Property Must file during the year for which the deduction is sought • o 2)Mobrie/Manufactured Homes not assessed as Real Property.Must f dltSn ')n � (• �7`•�ITOR County Auditor before March 31 of each year the deduction is sought G BS County Recorder See reverse side for additional instructions and qualifications. =redact ct b Y 2 e) istrzt Key number/legal desaip• Record number Page number (I I"1rJbn a,–I1—I d- Io3 -ba3. G, at'-o a-3 ao it+ 4393 Assessed value of real property as of Mortgage/Contact indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole March 7:want year Mardi 1.Current Tr date of application legal or equitable owner? T`T boll - ❑ Yes ❑ No If no,what Is his/her exact share of interest? If owned with someone other than space,indicate with whom If name on record's dRerent than that of applicant.indicate below Is the property in question:Annually Assessed ❑Real Property ❑MnuallyAssessed Mobile Home QC 6-1.1-7) C('e cit./. Ltn ton '-r-"-0C..l j What Taxing District? Has en1dedduuoion been requested on property a0i Li— / /32'7 ❑ Yes ❑ No [[GG..JJJT``` �tf .JS I AUDITOR I 20 20 20 � ���� Date(month,day.year) t i-.se rzr mr u,�.•,....,.- ..–.-- �7natfon is true and coned and that the applicant is a resident of Indiana and owner I contract buyer of the aforementioned properly on data application is filed. �l„ h Date(month,day.year) /' uG resident app cant(numbers et airy,state,and ZIP code) 2c08 (,lies+ BrutVLheV 13c,2 T-11. eKi 10 • 41767 O Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 I Date(month,day,Yeah Address of audweted person (number and sheet City,state,and ZIP code) .