HomeMy WebLinkAboutMortgage_Hutchinson a s STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
1 - i FOR DEDUCTION FROM ASSESSED VALUATION
y State Form 43709(R13/10-15)
Prescribed by Department of Local Government Finance
•
INSTRUCTIONS: File Mark
lb be filed in person or by mail. ,�jt_.
Filing Dates: 1) Real Property.Must be completed and dated in the calendar year for winch the deduction is sought ; p •.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the pro is i ' r •-• '•• dot
boated on or before January 5 of the immediately succeeding calendar year.
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the countx D� County Recorder
where the property is located during the twelve(12)months before March 31 of each year the deduction is sortJtft" .5 2017
See reverse side for additional instructions and qualifications.Qa_iiiedee,;(2,,,c)
T a t�Q/ pumbert legal descdPtion OIBRIAticoaV 'TY VI,
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f0/�/5 0100-clod. 3/d oo? �?o%csr. /6
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of appli ation /� legal or equitable owner?•/85aff) ❑ Yes ❑ No
If no,what is his/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 property in question:Annually Assessed
Real Property ❑ AnnuallyAssessed
• hbbtle Home(IC 6-1.1-7)
Name of mortgagee or contract seller QL. /0
(mob L/
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage
)g-7/ 2 (nZ) /�g -/O -46
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any H yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other on property for
in Indiana?
Yes ❑No current year? ❑Yes ❑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
records • .' —:_, _"-a. .`/ _:-:.-:'-_-."--.7.,..-f-^-',•"--I:.^.rNed in the county recorder's office)that is the basis for the deduction.
S oi5- `/l0 r J COUNTY AUDITOR
Deduct
Drawer NO
2 20 20 20 20
Signet Card NO. County - Date(month,day,year)
lie _DPIC - Li 3o - 4o/ S
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner l contra• buyer of the More/-n'.ned property on date application is filed-
S' tur:/ „,":2y / I Dare(month,day,year)
Full resident address of..•lxant(number and '- city.state, -it,ZIP code)
��' I s ' " •0 _ A I - on _ y7G'2-v
Person authorized by duty- - -d 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 fine not to exceed$10,000. •