HomeMy WebLinkAboutMortgage_Hudson •sn STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
1r`- •' FOR DEDUCTION FROM ASSESSED VALUATION
.•�. .- t+ State Form 43709(R12/6-14)
-\'ç-pi Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
Filing be Dad s:person or by may.
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the prop is u i •, ditor
located on or before January 5 of the immediately succeeding calendar year. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Properly:Must file with the County Auditor of the countf3p(r L
where the property is located during the twelve(12)months before March 31 of each year the deduction is soOightT Ur 2015
See reverse side for additional instructions and qualifications.
Appican wrier or contract buyer-see restricts son reverse side) _
4 G , ,>~L,r ht. X lwoto ei" ' GIRSOe g l Y
Tara DistppcA r ,v Key number l legal description R n ��-(fper
i�c nreZc„-) a4 -/d -DE- 30/ - 000. 3 5 g)- 0 LE c oi5 1 3 $ 70
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,Current year date of application legal or equitable owner?
S50o6 ❑ Yes ❑ No
If no,what is his/her exact share of interest? If owned with 50 t—�1-t- tha+.spouse,indicate with whom
If name on record is different than that of applicant,indicate below: `J1� �.�,yv�y��• ���5 F
�l4 vyx 1T it
Name of mortgagee or contract seller 5-7 FI -L_ M`�I n1 �1�
7(/ 3 o a C
• 1-C7_ IS
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) ' S S -
? t 00 C1
Name of assignee or other owner or holder of mortgage
�U(S— - 2
Address of assignee(number and street,city,st te, co e) -
Does applicant property in any If yes,what county? 8 What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes ❑No current year ❑Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction.
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/contract buyer of the aforementioned properly on date application is filed.
�/ Si ore(owners/u0 name) Date(month,day,year)vidonLi
u resident address of applicant(number and street cte,and ZIP code)
�-.E• t, c l dacanitQ t,r .city,
i na i a . .Lt 'f 4CP7v
Person authorized by duly executed Power f Attorney o by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,city state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000. P-,9