HomeMy WebLinkAboutMortgage_Garrett (10) l... STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
: 1: FOR DEDUCTION FROM ASSESSED VALUATION
Stale Form 43709(R13(10-15) 7T'
Presalbed b De rtment of Local Government Finance N
INSTRUCTIONS: y Ftle 111
To be filed in person or by mad. Fp m
Ring Dates 1) Real Property.Must be completed and dated in the calendar QC ! e
Must be filed or year for er of the county deduction the sought Q
postmarked with the County Auditor or County Recorder of the county where the properly is ❑ �Auditor
located on or before January 5 of the immediately succeeding calendar year. ty Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of g&un®��OUN
where the properly is located during the twelve(12)months before March 31 of ead,year the
See reverse side • .••lional instructions and qualifications. � ,( T Y AUDITOR
Taxing s:=P'. I � numbe Page tier/
+slue•��{{_,, ••- I Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
year I assessment daM,current year date of ap7 2 legal or equitable owner?❑ 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 ddferent than that of appricant,indicate below. Is perty in question:Annually Assessed
Real Property D AnnuallyAssessed
• Mobile Home(IC 6-11-7)
Name of mortgagee or contract seller
Address of mortgagee or contract seller(number and sheet cite:state,and ZIP wde��.�y7
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street city,state,and ZIP code) .•�''
--/ 0 91/ 9-Does applicant own property in any If yes,what county? What axing District? Has this deduction been requested If yes,state amount of deduction
other county on for
in Indiana? D Yes 0 No durrep nt yran ❑Yes ❑No
A person is not entailed 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(indudutg any home equity fine of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR
Drawer NO (;O ( L-P — 20 20 20 20
Card NO.
W 1 County Date(month,day,year)
we and foregoing information is true and correct and that the applicant is a resident of Indiana and
....••.,,.....,,.__�,,_. _._. __._./may.—_ . . r on data application is filed.
Signature,•wrrers b� Date(month, L year)
F F - address of applicant(num and street city,state,and ZIP code)
ur t.rot g cc I&W u/- O4-Crv6144-st; 42 4t166f---
Person authorized by duly executed Power of Niamey or by IC 8-11-12-0.7 Date(month,day,year)
Address of authorized person (number and street city,state,and LP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.