HomeMy WebLinkAboutMortgage_Garrison STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
�'` -'`�J FOR DEDUCTION FROM ASSESSED VALUATION
,:_: '. State Form 43709(R13110-15)
Prescribed by Department of Local Government Fiance
INSTRUCTIONS:
To be filed in person or by mail. Form filed with:
Filing Dates 1) Real Property Must be completed and dated in the calendar year for which the deduction is sought ((��(` ��pp Q
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property-Fs�'.T 1 8 Ey'county Auditor
located on or before January 5 of the immediately succeeding calendar year. 0 Court Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the coyg}yy
where the property is located during the twelve(12)months before March 31 of each year the deduction'
See reverse side for additional instructions and qualifications. f,I pS fl N f:fll I NTY Al I n I TOR
Apprrant(owner or contract -see mstrictions on reverse side) 1 _ �,
d 4 Crag\e.r,e. . r-cH O r- .
axing Key number legal Rewd number Page ber
V ale -09 - 1o3- aoa . �y- ®D9 . I $ 3r4'D3 -
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant
assacnent date,current year assessment date,current year date]1a li atbn L� owner?legal or equ a owner?
�+7 N.Q-a,, OCD.` es ElNo
It no,,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
tf name on record is different than that of appricant,indicate belay. Is the property in question:Annually Assessed
0 Real Property 0 Annually Assessed
Mobile Hone(IC 6-1.1-7)
Name of mortgagee contact seller /� -
W^e-\\S `11� Iu yD (T NrOc-r do r-.'
Address of mortgagee or contract seller(number a t city,state,and ZIP code) 4'
sb3, oI,v. -
Name of assignee or other owner or holder of mortgage
a-U ( y- 3ios
Address of assignee(number and street city,state,and ZIP code) �I
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction beer ""c((s �"/1-macI
other county on property for
in Indiana? ❑Yes ID No current year ❑Yes Ll No I
A person is not errblkd 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(inducting 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 contracto buyer of the aforementioned property on date application is filed.iiLowrre rka�L� Date(n1CIM,day,year)
\JFuull resid/enCa�dl/ddress of appr t(number/ and street,city,state,and( ZIP code)
J G 9. F to of er 1 `r</`'P /`O /F�'.'`'1 re/el H �W �bZ
Person authorized duty executed Power of Attorney or by IC 6-1.1-12a. L 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 S10,000.