HomeMy WebLinkAboutMortgage_Ruedlinger STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
€:. FOR DEDUCTION FROM ASSESSED VALUATION State Form 43709(R13/10.15)Presrn !I bed by Department of Local Government Finance ti e
INSTRUCTIONS: • File Mark -i
lb be filed in person or by mail. Ft tom,filed-with-
Filing Dates: 1) Real Properly Must be completed and dated in the calendar year for which the deduction is sought Z U I8
Must be filed or postrnarlced with the County Auditor or County Recorder of the county where the property is ❑ County Auditor
located 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 fig C u Recorder
where the property is located during the twelve(12)months before March 31 ofeach year the deduction is tC0�ry fJlyNnp ITOA
See reverse side for additional instructions and qualifications Up
Ap$cant .• eror contact buyer on reverse
4l.?.6 e/
T ' i Record munber Page number
Set ., al - .a'.3- OG• /a3- an. 4gs-a99 aoi 8 5/9J
1Z value of real• ••- as of Mort gage/Contract indebtedness unpaid as of Mortgage sole -
•assessment date,current year assessment date,current year of t Contract indebtedness unpaid as of legal or applra equitable f
/ q(/O ❑ Yes ❑ No
If no,what is his t her exact share of interest? if owned with someone other,indicate with whom
If name on record is different than that of applicant indicate below. Is the property m question:Annually Assessed
❑Real Property ❑ Annually Assessed
Mobile Home(IC 61.1-7)
Name of mortgagee or contract seller
Address of mortgagee or contract seller(number and street city,state.and ZIP code)
Name of assignee or other owner or holder of mortgage �o//U
��/��` Drawer NO
CCCJJJXCCC
Address of assignee(number and stree�/J„4;jjfe,crud LP e) _ter e 1 �)(/P,..1,,�[ —
Does applicant am property in any If yes.ylipi county? What Taxing District? Has this Card \'O. ...
other county (/ on prop
in Indiana? ❑Yes ❑No current• _
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness marts recomeo in me county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of
20 20 20_ 20 20 20 20
Signature of County Auditor County - Date(month,day,year)
I/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 I.. tract buyer of the aforeme•tinned property on date application is filed.
Signature td,...- . r.i nam: Date(month,day,year)
.2-7 trli..-IP/c.
Full .address of-•.-- • number and-.-1 city,state nd ZIP code
� el/ 3 -t _
Person authorized by duty executed Power of. .
ey or by IC a-,.,-,2-0-7 � ���`'
(month,day,year)
Address of authorized person (number and street dry,state,and ZIP code)
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The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.
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