HomeMy WebLinkAboutMortgage_Sokeland s STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
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.P FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R73I lit
Prescribed by Department ent o of Local Government Finance l r
•INSTRUCTIONS: ' F`f A'}
lb be filed in person or by mail. Form >.' : AM)
Filing Dates: 1) Real Properly.Must be completed and dated in the calendar year for which the deduction is sought
Must Must be filed or posf marked with the County Auditor or County Recorder of the county where the property is O I ra Auditor
located on or before January 5 of the immediately succeeding calendar year. ountty
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county � ❑ County Recorder
rem the property is located during the twelve(12)months before March 31 of each year the deducti sou..A/,, !ems
Ap trse si•, additional instructions and qualifications. ��BSDN l`n(J1V7 I'UDITDR Air ce
_Ad ti ! t l�/_/i_ftAA/ s_ r ,.t/LL__.J Air
g •�; `► l r,�� I'/3 ad 10016- 4036 ,71.nter rya.
Assessed value of real property as of Mortgage t Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of applcatpn/ 6 Z) legal or equitable owner?Yy'�77 ❑ Yes ❑ No
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Ifowned with someone other gait corvine,indicate with whom
(s the property in question:Annually Assessed
5 I E LA I f N�eal Property ❑ Mobile (I 6
U K F� u /� 47, .Lite. / Mobile Home(IC 6-11-7)
C� te,and ZIP code)
pAUl,of sire
d i 219,77,4 What Taring District? this deduction been requested If /ate n deduction
Iq4 5/ oo° acuinent year? ❑Yes ❑No
1Y t is a balance on the person's mortgage or contrail indebtedness that is recorded in the county
tit"` n$6. is recorded in the county recorder's office)that is the basis for the deduction.
/ t y/ /
COUNTY AUDITOR
' /�/_ L.Y�I 20 20 20 20
County Date(month,day,year)
�" d foregoing informations true and correct and that the applicant is a resident of Indiana and
//(,r. ate application is filed.
(t... Date(month,day,year)
7P cod�eJ)
f- -- Date(month,day.year)
Address of authorized person (number and sheet city,state,and ZIP code)
The penalties for penury can include imprisonment up to two and a half years and a fine not to exceed$10,000.