HomeMy WebLinkAboutMortgage_Kendall a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township I Year
lee FOR DEDUCTION FROM ASSESSED VALUATION
�'- State Form 43709(R13/10-15) Gb•�0f\ O. vim 'LW!
Prescribed by Department of Local Government Finance J 1 i 1
INSTRUCTIONS: _ File Mark
b be filed in person or by mail. Form filed wtth:
Filing Dates 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 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 the county El County Recorder
where the properly is located during the twelve(12)months before March 31 of each year the deduction is sought
See reverse
�gside
erffor additionalon'al instr reStriCtiOrtS uctions and qualifications.ion• I. 1 ' 'm( A contract n n �CP11T�C1��& K�d9l k .
Wig District. �_ r- m r .� �3�l 8 , �cjq Page j
Assessed value of real property as of Mortgage I Contract Sebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
ascxsmerd dale,anent year assessment date,wrest year date of appppl' iron/l goo o legal or equitable owner?
6 // fGJ 1nf�Yes ❑ No
t no,what is his/her exact share of interest? If awned vrith other than!tome,indicate with'whom
m name on record is different than that of applicant,indicate below I the property in question:Annually Assessed
Property ❑ Annually Assessed
• Motile Home(IC 6-1.1-7)
Name of mortgagee or contract seller Olci
cj_ -j}`(Jo^• tic
.
Address of mortgagee or contact seller(number and street city,state,and ZIP code) FILE I,!
•
Name of assignee or other owner or holder of iuuJydge APR 2 9 2019
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 dAlkiS+DlkC 3" •?c+.. es,state amount of deduction
�iana? ❑Yes ❑No ccuurre on nt yearperty? ❑Yes ❑No A DITOR
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 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
Signatu County Augitor County - Date(month.day,year)
Sneer- SWV .1� � (.n- 2q - iq . .
II We certify under the penalty of perjury that a above and foregoing information is true and coned and that the applicant is a resident of Indiana and
owner i contract buyer of the aforementioned property on date application is filed.
`/yin re(MI/I111irKae�rg ffu`lll',name)
)/j1'' {LX(/,/'',W�Yn''/'L`�L�-{(n'/1 Date(month,day,year)
F _reside t address of appjkanf(number and see,city, t tie, ) � - kei
1 Or
Person authorized by duly executed Porter`ooff`,Attoomey or by IC 6-1.1-12-0.7 D Date(month,day,yeik
k- Zq• li
Address of authorized person (number and street city:state.and LP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.