HomeMy WebLinkAboutMortgage_Maurer (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4, FOR DEDUCTION FROM ASSESSED VALUATION jjj'��� 1 �
- J State Form 43709 Department/tofL
Pam by De ant of Loral Government Finance
He Mark
INSTRUCTIONS: C[��❑❑
To be filed in person or by mail with the CountyAuditor or County Recorder of the county where the property is locy31 P 2 i F'- 'v..with:
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought li • my Auditor
2)Mobile/Manufactured Homes not assessed as Real Property Must Re during the twelve(12)mo ls ,
before March 31 of each year the deductions sought - 1. fil?R►F.i County Recorder
See reverse side for additional instructions and qua lifications. GIBSON COU • • • •
Aap t(owrorer buyer-see resakfionsmreverse side) � /�✓� ,,,---
T M /1 Key � ;legal/e /f - 3 D�. v 2 3 -Q Z 6 Record number Page number p
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the apprvant the sole
March 1;anent year March 1,current year date of app.S// D O 1 El Yes Yes ❑ oN
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant indicate below: Is the property in question:Annually Assessed
❑Real Prup„rty ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller / _ __ _ _ ___ __
Address of mortgagee or contract seller(number and`.street,t,dry.state,and ZIP code) /y�
1 ' I ay.,f 3ptotcjyL
—
Name of assignee or other owner or holder of mortgaged-,^ ) ,r _ —
Address of ssignee(number and street,c4 state,and ZIP code) W I�... sx.(Co p/`
G� 2Zienee_ _33-7 Pr /s- 14 8 —
Does applicant own property in any other If yes,what county? What Tarring
county in Indiana?
❑ Yes ❑ No •
COUNTY AUDITOR '
Deduction approved in the amount of: •
•
20 20 20 20 20 20 20
Signature of County Ador County Date(month.day,year)
, e _ eA _We I I J-Wcertify 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.
Sbc (ov ) i Date(month,day,year)
Full reset of appfzant(number and gime,a7y, te,and"ZIP code)
's lt\z S l►X),\-,erg S} 1/4) -8C II\ TA) C-1-1le(4 a •
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authodzed person (number and street,dty,state.end ZIP code)