HomeMy WebLinkAboutMortgage_Joyce (3) ma . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
, County Township Year
r FOR DEDUCTION FROM ASSESSED VALUATION
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State Form 43709(R13/1415) ��--''11 ''gg'��
Presenbed by Department of Local Government Finance FILED INSTRUCTIONS: File Mark
Te be filed in person or by mad. Ned with:
Ong Dates: 1) Real Property:Must be completed and dated in the calendar year for which the d • is fl'lit.
Must be Red or postmarked with the CountyAuddor or Cowdy Recorder of the `the property is County Auditor
located on or before January 5 of the immediately succeeding calendar year. County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property.Must file with the A •ffo_;,' , e county
where the property is located during the twelve(12)months before March 31 of-.tf •, :.7jr.ti,nr.. ., is
e it
See reverse side for additional instructions and qualifications. t{p)TY AU DITO '
�/� /� IBSOW CO
AppGpnt(curter or /n ; 1r/ /\.�/l.''1Ll/� �..,�" ��/�J,�(�J�?.CO1 �f Jp. y�p�a��(/,'
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■ �}(J:,JbI(1�� Vl SD I oLO-1(0—/ 01.. l..J�J r `-I a l '17'
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value of real peaperly as of I Contact indebtedness unpaid as of - Mortgage I Contract indebtedness unpaid as of Is due applicant the sole
��_ ._.,dale,amnemt year /�data date d app&abon legal or equitable owner?
■ W� ❑ Yes ❑ No
If no,what is his/her exact shared interest? r If owned Mei someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below is the property in question:Annually Assessed
❑ Real Property ❑ Amua%y Assessed 6-1.1-7)
Nana of mortgagee or=tract seta t A Mobile Horne
/AI�•C fj i
Address of mortgagee or contract seller( and steel oft%state,end ZI e)
Name of assi ----,y I I ` , �O y n C _
Addresda /4 Atitti NTO cj C C - .
o I n—;n 1 tt Ing District? Has this dedurSmn burl!requested dyes,sate amount of deduction
other • ! �f01 anpropedyroc
m Indana? current year? ❑Yes ❑No
A person is, nce on the person's mortgage or contract indebtedness that is recorded in the county '
recorders office(naudng any home equity m,e to ._.___.led in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount at
20 20 20 20 20 20 20
SignaNre of r/ ,C.�x% county At.. Date( l d 710�7
I I We certify under the penalty of perjury that t a dr�oregoing'udormabon is true and correct and that the applicant is a resident of Indiana and
owner t contract buyer of the aforementioned p n date application is filed.
�,efs, marsa)� I Date(month,day,yew)
Resident—JyJ_t adddressy dfff'appl_//applcant and street city sate,and ZIP code)
r/24-Oi 5. 20O L= /44(.f3STA o-r Iti 4 7 Is 3,
person authorized by duly executed Power of Attorney or by IC 6-1.1.12-0.7 Date(month,day,year)
Address of authorized person (number and streets obi,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S10.000. -
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