HomeMy WebLinkAboutMortgage_Marionr : STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS I County Township Year
�� FOR DEDUCTION FROM ASSESSED VALUATION ` } ?
i,^ State Form 43709(R73l10.75)
- Prescribed by Department of Local Government Finance
INSTRUCTIONS: " SEP 6 nth deMartc
To be filed in person or by mail Form filed with:
Filing Oates 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 county where a pe rs County Auditor
boated on or before January 5 of the immediately succeeding calendar year. p(('Mt.<f rA' County Recorder
2) Mobile I Manufactured Homes not assessed as Real Property:Must file with the Coin@ � is-sought
�,t*AU D T
where the property is located during the twelve(12)months before March 31 of each year
See reverse side for additional instructions and quafificafions.
Appficap((owm� -or con buyer-see rastrktions on rave rode) 1
TalDistria r Key number/legal description Record number Page number
A a 6 - td -o7 - Zoy .oba, - 600 - of- 82.1
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the ap nt the sole '
assessment date,auresd year assessment date,current year date of appf legal or equitable owner?
. Jf Ll 19 ❑ yes D No
If no,what is his/her exact share of interest? If owned with someone other than sprvrc..,indicate with whom
If name on record is different than that of applicant,indicate beb+r. Is the property in question:Annually Assessed
0 Real Property 0 Annually Assessed
• Mobile Horne(IC 6-1.1-7)
Name of mortgagee or c/..t/J,4/Y• ��
Address of mortgagee or contatl setter(number and bfreet,city,state,a LP code)
Name of assignee or other owner or holder of mortgage Drawer NO (;(31
Address of assignee(number and street city,state,and ZIP code) n5
l/.�J)
Does applicant own property in any If yes,what county? what Taxing District? It Card NO. ,!✓, r
in Indiana? ❑Yes ❑No a
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is femme°us um u.itnty
recorder's office(including any home equity fine of credit that is warded 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
ownerr!contract buyer of the aforementioned property on date application is filed.
Sigiraarr r1 /t '^/ 0{L Date(month,day,year)
UniCkt
F -.,.tent address applicant(numer and .nb .city,state,and code)
7 a O N d�� r -GL�- ..4-- k 7 (o '7 o
Person authorized by duty execute r of Attorney or by IC 1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street any,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S10,000.