HomeMy WebLinkAboutMortgage_Parks (2) a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS :ounty Township I Year
e-_- FOR DEDUCTION FROM ASSESSED VALUATION
e) r State Form 43709(R12/6-14)
� ,a r Prescribed by Department of Local Government Finance F I L !/
INSTRUCTIONS: File Mark
To be Sled in person or by mail. eQ t ,,((�(''�� For,filed with:
�
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the ed6c n is 58f/�ht.
Must be Sled or postmarked with the County Auditor or County Recorder of the county where the property is LY! County Auditor
located on or before January 5 of the immediately succeeding calendar year. fL=1, Court Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with Mir,r: •.• dinflgu.rf Lthe county County
where the property is located durin the twelve(12)months before Marf34R�c(r F r�Iti-.UU9�U fought —
See reverse side for a.ditional instructions and all . ations. h(
Applicant(owner or .c uyer-see resin' ons v side)
Taxi . thcl Key number I legal description Record number Page number
S. ! I) 19249-dal Soo-ocn. a39-paL, 1lP r) to
Assess- value of real propertyas of Mortgage I ContracUpdebtedness unpaid as of Mortgage I Contract indebtedness unpaid as o Is the app ipnt the sole
March ,current year March 1,current�Ce JTI/ ' date of application legal or equiable owner?
`/ J/ 0 ❑ Yes ❑ No
If no,what is his I 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 Property ❑ Annually Assessed
Canc. Mobile Home(IC 6-1.1-7)
Name of mortgagee'or contract seller
Address of or contract seller(number and street,cirystate,and ZIP codode)
Drawer NO.-20/.:Y.... ..
(�/`— What Taxing District? Has this deduction been requested If yes,sate amount of deduction
Ca r(l (�0. ✓ �( 0 on property for
............. current year? ❑Yes ❑No
Y
•--•'. 'n has a balance on the person's mortgage or contract indebtedness that is recorded in the county
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 n. r• •"or / County o Date(mon anyeay) l /
3 5&-
41111 4110 at
I We certify under the penalty of perjury that the above and fo egoing information is true and correct and that the applicant is a resident of Indiana and
owner I con t buyer of the aforementioned property on date application is filed.
i ture(ow f full!�m �.n Date(month,day,year)
2_
ull resident address of applicant(number and street,city state and ZIP code)
4 0 /34205 �C�- - (f)!31
voc so authorized 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 street,city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a tine not to exceed$10,000.