HomeMy WebLinkAboutMortgage_Connor n" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
E s FOR DEDUCTION FROM ASSESSED VALUATION
�'� State Fonn 43709(R13 1 10-15)
`---i- Presalbed by Department of Local Government Fnance a
nsnzucnoHS:
1 Fi M rk
lb be filed in person or by mail. Font filed with:
Filing Dates: 1) Real Property Must be completed and dated in the calendar year for which the deduction is sou t
Must be filed or postmarked with the County Auditor or County Recorder of the county whom tit 14 2018 ❑ 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 County Auditor o the county
where the property is located during the twelve(12)months before March 31 of each year the • is
See reverse side for additional instructions and qualifications. Fst
(owner or tracbuyer-seeresttcobnsonreverseside) GIrsSOrt COUNTY AUDITOR
Key !legar description Record number Page number
_ a4_ a3 -/4 - coo. -o€a. Gi ? -1.-oa.Y go 17 sa3
value of reai property as of Mortgage I Contract indebtedness unpaid as of Mortgage t Contact indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment dale,current year date of applicationil legal or equitable owner?No
If no,what is his/her exact share of interest? If owned with someone� O ❑ Yes ❑indicate ttCan spouse,indicate cate wi h whom
If name on record is efferent than that of applicant,indicate below: Is property in question:Annually Assessed
Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
LNL (X e&
Address of mortgagee or contact seller(number and street.dry,state.and ZIP code)
Name of assignee or other owner or holder of mortgage .
X 0 -. s 13 —
Add of assignee(number and sheet.any,s e LP coda) oi- /rt 4 —
Does ap • t awn property in any Ittyyes,what county? C_•what Taxing District? Has th � — '
other county , pro
in Indiana? Yes ❑No , ounen _
A person is not entitled to this deduction unless the person has a balance on the person's mod CO V\ V' C \(-'
recorders office(including any home equity line of credit that is recorded in the county recorde
COUNTY AUDITOR R
Deduction approved to the amount of 1 1 LJ 0 a
-
20 20 20 20
Signature of County Auditor County -
I/We certify under the penalty of perjury that the above and foregoing information is true a
owner I contract buyer of the aforementioned property on date application is filed.
kSignature( NB me) �t iy ,C.,/�t� T�j L/ ? Date(month,day,yeas)of
' ' &3 7 R e"
7 (('/(/ric/� state.a/laiA'--! ? T 7603 9•
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 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$10,000. .