HomeMy WebLinkAboutMortgage_Hudson t STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
tf` .
'_�,�: FOR DEDUCTION FROM ASSESSED VALUATION
State Fonn 43709(R13/10-15)
" — Presorted by Department of Local Govemment Finance
INSTRUCTIONS: File Mark
To be filed in person or by mail. Form filed with:
Filing Oates 1) Real Properly: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 4t. - is per- County Auditor
located on or before January 5 of the immediately succeeding calendar year. P
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Au•-.A •f • I)1 ,1 •arty Recorder
where the property is located during the twelve(12)months before March 31 of each year the d+ukrwtion is sought
See reverse side for additional instructions and qualifications.
AppSra rrerorwntradbaye resbttlan on ide) MAY 1 2019
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Taxing D" Key number/legal description !� �� I Ynit Page number
,��,• o‘P/b-%�Cr'�ZDDi 9GIgcON COUNTY C ITJ�
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of"�jlJs a cup sole
assessment date,current year assessment date current year date — Ilegal or Nu' a owner?
7/ 000tttRRR �ia I Yes ID No
If no,what is his I her exact share of interest? If owned with someone er than spouse,in " with whom
tf name on record is diferent than that of applicant,indicate beldw: Is the party in question:Annually Assessed
Property ❑ Annually Assessed
' Mobile Home(IC 6-1.1-7)
&ofmongagee � lerO /
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Tess of coo gages or contract seller(number and abeet,oily,state,and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number an beet,city,state,and ZIP code)
Does applicant own p in any If yes,what county? What Taxing District? Has this deduction been requested -If yes,state amount of deduction
Indiana? Yes Yes ❑No current year?on property ❑
in 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 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
Signatire County Auditor County • Date(month,d ye
I/ I1/u_ 'ofpe `7` t tis /&/ 9.
/We certify under the penalty of perjury that the and foregoing information is true and correct and that the applicant is res ant of Indiana and
owner/contract buyer of the aforementioned prope on date application is filed.
/ Signature(own name) Date(month,day,year)
N, �Fuo resident`/G 9 applicant(number and street,city state,te.and ZIP code))C Person authorized by duty executed Power of Attorney or by IC 6-1.1-12G-0.7R Y Cw✓ 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. •