HomeMy WebLinkAboutMortgage_Garrett STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
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FOR DEDUCTION FROM ASSESSED VALUATION
-:• State Femn 43709(R13/10.15)
Prescribed by Department of Local Government Finance
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be filed in
INSTRUCTIONS: File V ==
To •
person or by mail. qpR .rtn filed • Cr
Filing Dates: 1) Real Property.Must be completed and dated in the calendar year for which the deduction is sought ,.Q
Must be filed or postmarked with the County Auditor or County Recorder of the county where thepprrooperty iJ M e172,9rity Auditor
boated on or before January 5 of the immediately succeeding calendar year. WO r- • • County Recorder
2) Mobile I Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the ably 4. -d9
where the properly is located during the twelve(12)months before March 31 of each year the deduction is—fig", ,7t:
See reverse side for additional i s and quail NjyA •
Applicant a capon buyer- m n gje'side) �ufj0
axing t, Key I descd Record number Page u ber
. Or $/ ' .
.o of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole •
. - -nt date,curtest year assessment date,current year date of appffation •• legal or equitable owner?
YO OW ❑ Yes ❑ No
If not:what is his/her exact share of erterest? If owned with ne ott(er than spouse,indicate with whom
If name on record is different than that of applicant,indicate below. I the property in question:Annually Assessed
Real Property ❑ Annually Assessed
•,/ � Mobile Home(IC 6-1.1-7)
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Name mortgagee or contract seller v
Address of mortgagee or contract seller(number and street city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage �,/CL"""!/���
Address of assignee(number and street city,�P code) /� -/a �/.
Does applicant own property in any If yes,what What Taxing District? Has this uction been requested If yes,state amount of dad
uWWCUMniommrf((•
other
-aana? ❑Yes 0 No coun eyertay ❑Yes D 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
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Signature of County Auditor -- - Co /yam .f}`.I{ ny^�f�
I/We certify under the penalty of perjury that the above and foregoing informal (u\ � ed 1 - 0`"`-1 i ndiana and
owner!contract buyer of the aforementioned property on date application is file S�
Signature(owners fun name) /� ^
...,1 Full resident address of applicant(number and sweet city,state,and ZIP code) -- I �U f o C)9
( 1 � L. 2 W • �� S n
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 (Dare(month,vo„,__,
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. _