HomeMy WebLinkAboutMortgage_Morgan (3) �, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
jFOR DEDUCTION FROM ASSESSED VALUATION
State rorm43709(R13/fals)Prescr ibed by Department of Local Government finance INSTRUCTIONS: ILED
To be hied in person or by mail. F,,
Filing Dates: 1 Real Property:Must be completed and dated in the calendar year for which the deduction is sought. �U - 1
Must be hied or postmarked with the CountyAudtor or County Recorder of the county where the property is ❑ County Auditor
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 county •❑ Co voider
where the property is located during t;r twelve(12)months before March 31 of each year the deductiorsrs
See reverse side for addtionalinstructions and q - r•. •ns. Vl COUNTY AUDITOR
AppGwnt ,A . or contrail a restrictions. -verse side)
A di O,Ia.
T. `•.,� . , // 4� Key /legal description Record nornber Page number
! f �i � 7299970-x700- t9Oo7. / 7�- 00 l 7 • 7,9 s o
value as of indebtedness unpaid as of Mortgage indebtedness unpaid as of
assessment date,anent year assessment date,amain year f application �or eoow�n g
6.o ❑ Yes 0 N
•
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name an record S diferent than that of applicant,mdrtate below. Is property In question:AnnualyAssessed
Real Property ❑ Annually Assessed
Se Molzlt Home(!C 61.1-7)
Name of mortgag�or�trad steer rf��j'{(�
Address of mortgagee or contrail sever(num street city state,and ZIP code)
•
Name of assignee or other owner or molder of mortga(� , . .` " e . - !V - ✓ - 9 4l. /� �'7V
Address of assignee(number and street aty,state,ant P e)
Does applicant own property in any If yes,what county? . Ylhat Taxing District! Has this deduction been requested If yes,state amount of deduction
other
indian�a? ❑Yes 0 N - ? ❑Yes 0 N _
A person is not entitled to this deduction unless the person has a balance on the person's mo --'" '^°r:o ramrded.in the county
recorder's office(including any home equity fine of a-edt that is recorded in the county recorc 9'7 q n.) JAS. 4
COUNTY AUDITOR •
/ ',('nl Fl•31 4A- ��
Deduction approved in the amount of _i't/•r
•
20 20 20 20 /r1— a?9So
•
Signature of County Atator County
I
11 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/contract buyer of the aforementioned property on date application is filed.
l ` -o (owners fve - Date(month,day,year)
•\e address of applicant(n : .- :,"rf/�and
141 F, Lo i`:OS' O`C a\ c� L iJ L(74 46
Person au' by duly executed Power of Attorney or by IC 6-1.1_12-0.7 Q r Date(month,day,year)
Address of authored per son (number and street ahy,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.