HomeMy WebLinkAboutMortgage_McCaleb at...._ STATEMENT OF MORTGAGE OR CONTRACT IND TIIE,S ' `` .unty Township Year
FOR DEDUCTION FROM ASSESSED VALUATIO
state Fenn 43709(R11/609) JAN 0 9 •0I5
Presaibed by Department of Local Government Finane
File Mark
INS7RUC77ONS: t••- . ■ .i - _ .
lb be fled in person or by mail with the County Auditor or County Recorder of the county wh- ,.. v111114lltr CDR Farm coed with:
Ring Dates: 1) Real Property:Must file during the year for which the deduction is so Oj,,,nth COUN D1r `y County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property:Must g the twelve(12)months �,rLJ
before March 31 of each year the deduction is sought - County Recorder
See reverse side for additional instructions and qualifications. �i
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T Key number/legal desarp' UQ'J r ' 1€94/0,1 r Record Page n
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
Mardi 1:mrent year hearth 1,amens year 6,a date of apt ton legal or equitable owner?
47 351302. o ❑ Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
It name on record is different than that of applicant.Indicate below. Is the property in question:AnnualyAssessed
❑Real Property ❑AnnuallyAssessed
Mobile Hoare QC 6-l.1-7)
Name of mortgagee or contra ylle�� , �Aa ix 0
Address of mortgagee or contract seller(number and street cdy state,and ZIP code)
Name of assignee or other owner or holder of mortgage
r
Address of assignee(number and street city,state,and ZIP code) CI `"� -44 k3 , �5� i ��
Does applicant own property in any other ayes,what county? •
it property
county in Indiana? ❑ No In I Q
❑ Yes ��r�.. O ( �I ❑ No
COUNTY AUDITOR \---
Deduction approved in the amount of: •
20 20 20 20 20 20 20
Signature of County Auditor - County Date(month,day,year)
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 1.. tract buyer of the aforementioned property on date application is filed.
Signature hA ://`/C', ' // Da/te,77 day,e ygar)
Full s"•ent address of,pplicantt(num rr aand street airy,stare,and ZIP code) (/y/70[
, Y/j, S
,q..,,,.,-S-- j7,ei%dc...w Ad g74"7d
P. -• authorized by duly exe cuted Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and sheet qty.state,and ZIP code) .