HomeMy WebLinkAboutMortgage_Paris (2) xa STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
kit J FOR DEDUCTION FROM ASSESSED VALUATION
-: State Form 43709(R13/10-15)
Prescribed by Department of Local Government Finance FILED
INSTRUCTIONS: - File Mark
To be filed in person or by mail. JUL 3 1 2t*nn filed with:
Filing Dates: 1) Real Properly Must be completed and dated in the calendar year for which the deduction is sought
Must be filed orposbnarked with the County Auditor or County Recorder of the county wham the pro rty is ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. County Recorder
2) Mobile I Manufactured Homes not assessed as Real Property:Must fife with the County Agdifor of
where the property is located during the twelve(12)months before Mardi 31 ofeach year the ftlaggatraeaddrigY AUDI rOR
See reverse side for additional i and quafrficafions.
Applicant •• _ or contract buyer-ntt��' son reverse side) .
s (2/i�C/J-
Taxin.L. • . Key number/legal description Record number Page number
jU� a(p-ra -ors-toy -ooa . 0 8) - 0 � p ,
Assessed value of real property as of Mort gage/Conaact indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
(p 4, o 0 0 ❑ Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,i ndcate with whom i
H name on record is different than that of appliant,indicate belay'. __. I Is the property m question:Annually Assessed
• ‘60---10-1--- Peat-,, Ci I , n C61.1-7)
Name of contract seller
IW1 1rA id(1 n'A (�//('
v s.. ,
Address of mortgagee or contract seller(number and street city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage
/8 -01q.)t
Address of assignee(number and street city,state,and ZIP code)
Does applicant own property in any .If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
atteraa re� ❑mIndin ❑Yes ❑No on year? Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorders 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 - Dare(month,day,year)
•
I/We certify under the penalty of perjury that the above and foregoing information is two and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is Red.
- Signature(Amer's full name— Date(month,day,year)
r•
.ate-'.- 'address of-..=-.- umber and(stre�et�city, --.4#an. P..) .
/110 9 /L-e'C- • /).-C/x-Ce.tir .-- -' ce 7 �0 7
Person authorized by duly executed '. of Attorney or by[CB-IA-12-0.7 /' Date(month,day,year)
Address of authorized person (number and street city state,and ZIP code)
1 The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.