HomeMy WebLinkAboutMortgage_Satterfield � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
� County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
St.-'a Form 43709(R73 710.15) p-�
Presatbed by Department of Local Government Finance F I L P -III INSTRUCTIONS: H� F-1
To be filed in person or by mall. • Form tiled vith:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is soughq c p 7 ZO 1
Must be filed or postmarked with the County Auditor or County Recorder of the county where the pro ty r is ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. ��fIII��'
2) Mobile/Manufactured Homes not assessed as Real Property.Must tile with the County Auditor of the my Recorder
%stem the property is located during the twelve(12)months before March 31 of each year the dedu
See reverse side for additional instructions and qualifications. nt r;OUN7Y AUDITOR •
Applcant(owner orcontraa buyer-see restrictions on reverse side) - . - CIB�O _ .
�T District Key ntanber description Record number Page number
cr.a ` alb • O5 - 3 ti- aad _ COSi. 52 -a.t ? do/ 3747
value dread property a€'of Mortgaged Contract indebtedness unpaid as of • Mortgage t Contract ctlaMadness unpaid as of Is the applicant the sole
assessment dale,eared year ma t date,anent year date of application legal or equrlable owner?
t"tetx O O n D Yes ❑ No
on
If no,what is his I her exact share of interest? If owned with someone other than spouse,indicate with whom
It name on record is different than that of applicant indicate below: Is the property in question:Annually Assessed
D Real Property ❑ Annually Assessed
Mobile Home(1C 6-1.1-7)
Name of mortgagee or trct Name of mortgagee or contract seller
./'t 4r `nn N
Address of mortgagee or contrail seller(number and street,city,state,and ZIP s)
.
Name of assignee or other owner or holder of mortgage
•
Address of assignee(further and street rally,stake,and ZIP code) - (1 n (1,. c ��++--tt��-�-�
Does applicant own property in any If yes,what county? - What Taxing District? He , 1 ' , _ k ' ton
other in DMIara? Elves ❑No an
\ .(1 r�
A person is not entitled to this deduction unless the person has a balance on the person's m w>c -Sr—n-y�. .`� ` ' panty
recorder's office(including any home equity fine of eredd that is recorded in the county recoi ^� �r Ci-1,`-
COUNTY AUDITOR • �ci1 U 11 --31 (.a I
Deduction approved in the amountot Liu vHoo _orb
20 20 20 20 20 20 20
signature of CountyAudiia County Date(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true and corned and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned . .perty on date application is filed.
KSignalise las i • r . , / Date 4(m(month,day,year)
KRA a•: — appGprd(number arch street state. -0 P�de) !! 7/7 D( "
, a37 /J 350 1 i2z r� Y 7
authorized by duly executed Power af Aitomey or by IC 6-1.1-12 417 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 510,000.