HomeMy WebLinkAboutMortgage_Howard (3) g':„. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
• r. t' FOR DEDUCTION FROM ASSESSED VALUATION
3:. . State Form 43709(R13/10-15) -
Prescribed by Department of Local Government Finance I 1F4
INSTRUCTIONS: File Mark
To be filed in person or by mad JUN 1 W with:
Filing Dates: 1) Real Properly:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or posbnarked with the County Auddor or County Recorder of the county where the property is ❑ County Auditor ,
located on or before January 5 of the immediately succeeding calendar year. • unty Recorder
2) Mobile/Manufachned Homes not assessed as Real Property.Must file with the County Auditor of the co
where the property is located during the twelve(12)months before March 31 of each year the dedeciglifiteCPACOU I Y AU UI I UN
See reverse side for additional instructions and qualifications.
Applicant(orvr��,Trrcontract buyer-see/esti •' on reverse side)11�� -
Y rSLon nu 0 r. molt
Taxing District Key n legal description U Record r P nu r
R v a6 - a- n - ( o ( - on , z31--Cxw a5BS
Assessed value of real proper/as of Mortgage!Contract indebtedness unpaid as of • Mortgage/Contract indebtedness unpaid as of Is the app&ant the sole
assessment date,ascent year asset date,=vent year date of application legal o le owner?
& ( OS (� ❑ No
If no,what is his/her exact share of interest? r If owned with someone other than%Insigne indicate with whom
N name on record is different than that of appicant,Indicate below I the properly In question:Annually Assessed
• eal Property ❑ AnnuaflyAssessed
Mobie Home(1C 61.1-7)
Name of mortgagee w contract seller
Address of`nortgagee or anrract seller(number and street,ay,state,and ZIP code) .
Name of assignee or other owner or holder of mortgage- ,
°rawer N
Address of assignee(number and street,thy ate,and ZIP code) • �.....�........... .
•Does applicant own property in any tf yes,what county? . what Taxing District! Ca rfj No. 2s� /deduction other
in ❑Yes Otto • I tw .... .
A person is not waled to this deduction unless the person has a balance on the person's mortgage or contract inueow...._- I in the county •
recorder's office(inducing any home equity fine of credrt that is recorded in the county recorder's office)that is the basis for the deduces,..
COUNTYAUDITOR - -
Deduction approved in the amount of
20 20 20 20 20 20 20
•
Signature of CountyAm:Nor Cap* Date(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing'udornabon is true and cored and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signature(• Y- -, -, -) Date(month,day.year)
1,1Q / G//G/Zo<J
Fctl r- , .. .- ., ....,•■■. number: ..street,city,ate,and ZIP code)
,/q/o E
audor ed dfy-.:.,._.Power ofAttorney-. . IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,ray,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.