HomeMy WebLinkAboutMortgage_Pond s., STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Courtly Township Year
'=J FOR DEDUCTION FROM ASSESSED VALUATION Y �1
�'. State Pam 43709 Department Y L E D
Prescribed by Department of Local Government Finance
INSTRUCTIONS: _ File Mark
To be filed in person or by mail j r-, oltvitilti
Filing Dates 1) Real Property Must be completed and dated in the calendar year for which the deduction is sought
Must be filed or postmarked with the County Auditor or County Recorder of the aunty where the property is ❑ County Auditor
located on or be!cm January 5 of the immediatey suaaeding calendar year.
• -th ecerder
2) Mobile/Manufactured Homes not arse Real Properly:Must file with the County Auditor of the county �i .�q�Mti1 i
where the properly is located during the 02)rrwritlrs before March 31 of each yeardie deduction is ION CO • I Y AU U f I UK
See reverse side additional instructions and quafrficafio ,/ �7(�� ;a h 31 of each
/f//;
Applicant(/� arYerc user / _ /L. L/r LY
T Key nut/legal desciption(� Read n Page number
fit // D �‘- /4,700� f In
Assessed value of real properly of (e_Ao_dera- aa0.
ortgage/Contact indebtedness unpaid as of Mortgage r Contract indebtedness unpaid as of Is the applicant the sole •
assessment date,cant year sv_ssment date,current year date of application �� QU�f legal or equitable owner?
SO; e ❑ Yes ❑ No
U no,what is his/her exact share of interest? If wined with someone other than spouse,indicate with whom
. K name on record is different than that of applicant,indicate below. Is property in question Annually Assessed
Real Property ❑ AnnuallyAssessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller y�
Ode/// 4e/e_ ..
Address of mortgagee or contract seller(number and street city,state,and ZIP code)
Nacre of assignee or other owner or holder of mortgage J��1tV� 1
Address of assignee(number and sheet city,state,and ZIP code) Po L)D -1-n v
Does applicant win property in any If yes,what county? Mat Taxing District? � r l•, - I L'- deduction
other d-�-
inlndiancea? ❑Yes El No '1
• A person is not entitled to this deduction unless the person has a balance on the i C�r�y r the courtly
recorders office(including any home equity line of credit that is recorded in the a eZ,tl Ana /-/�
COUNTY A ,r,
Deduction approved in the amount of 50,WO
20 20 20 20_ B t :0
Signature of County Auditor C ' v
I/We certify under the penalty of perjury that the above and foregoing infonna- ldiana and
owner/contract buyer of the aforementioned property on date application is f b
S u ru9.rr:) n I-- -.,,,,-..•,•
4 Full resident address of apppli ant/ (number andgme r,city.state,and ZIP code
/7(/ s 2,2s E byr,rcisco, .S,/ 17K77
Person authorized by duly executed flower of Attorney or by IC 6-1.1-12-0.7 Data(month,day,year)
Address of authorized person (number and street dty,state,and ZIP code)
The penalties for perjury can include imprisonment upo two and a half years and a fine not to exceed$10,000.