HomeMy WebLinkAboutMortgage_Garrett (2) a° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
ter-%:- FOR DEDUCTION FROM ASSESSED VALUATION
-� .,i` Sta,e Form 43709(R12/6-14) DU E E EDF T A ON
'% ;'-�' Prescribed by Department of Local Government Finance rang(E7
•• 5ubj to
INSTRUCTIONS: day of _File Mark
To be filed in person or by mail. — MAY 16, LO16 Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for ich the ..0 '•. -.ught.-Au.itor
Must be filed or postmarked with the County Auditor or County Re..�.(: "t, he the ,...- IS ❑ County Auditor
located on or before January 5 of the immediately succeeding Galena-I' 7J. , �,"'If�I. i .y I. on ounty
�I. -, �I,m11. ❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Properly:Must file It h=�✓.. y+ .t•4(:f/ - -Pe elY
where the property is located during the twelve(12)months before M1Mdb� �-- fit�-�! "�.��
See reverse side for additional instructions and qualifications.
Applicant(. •- . nntractb er-seaf$�tndi reverse side)
Taxin District , i l/��Keeyy number/legal description Record number Page number
• i! 0 026-/7-09-100--0(1,3. exo7. Oc9,1 A0, 6 199 /
vain."(real property .f Mortgag,a f�.Cpntract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,amen year / March n ear date of application legal or equitable owner?
. O lid 0 00 ❑ Yes ❑ No
If no,what is his I her exact share of interest? / lf 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
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contact seller /w� /'y` /eI ,1 ,�
•
Address of mortgagee or contract seller(number and street, rt11 state,and ZIP code) L/l/ ' , W)
Name of assignee or other owner or holder of mortgage
,. —
Address of assignee(number and street,city,state,and ZIP code) -
0/
Does applicant own property in any If yes,what county? What Taxing District? Has thi. Drawer N O �
other county on pmt
/ �-y.� I
in other
Indiana?county ❑Yes ❑No current ")(-.I� _
A person is not entitled to this deduction unless the person has a balance on the person's mortg
Card ,O.
recorder's office(including any home equity line of credit that is recorded in the county recorder _._. _._ ..,,...
COUNTY AUDITOR .
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signatur unty Auditor • County '�`e `^_""'b"'` Date(coon ay.year)
'MA t 75/6— 2,
I/We certify under the penalty of perjury that the abov an oregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
•
Signature owner's name) M �� p Date(month,day,year)
ull resident addr f applicant(number and street,city,state,and ZIP code)
�SSa.? 1 i0SO let' 0WEWSVILLF_ LN. LI7(� /S
erson authorized by duty executed Paver of Attorney or by IC 6-11-12-0.7 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 S10,000.