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HomeMy WebLinkAboutMortgage_Carson t . t,.,,,t.. .1 n: toil • . rlf ,no. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year a+_" q:.1 FOR DEDUCTION FROM ASSESSED VALUATION t y_ tq Le In? State Form 43709(R13/10-15) Prescribed by Department of Local Government Finance in P 6'1 1(3 ,0.2o INSTRUCTIONS: File Mark 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. 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. ❑ County Recorder 2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county where the property is located during the twelve(12)months before March 31 of each year the deduction is sought. See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) 5-e#-cry A - Casson a- Cassandra E. Carson +1/ti Taxing District Key number/legal descripuon Record nun er /Page pprPq{S D(0 - oa- s9 -03a - oo0 . CDS8— pi q 2J ci IUUUy/�„' {I Assessed value of real property as of Mortgage/Contact 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? o2 Sj 000. 0 0 (ErYes ❑ No If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed Er-Real Property ❑ Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller yy EJo nsvi r 'Pack'PackersFu c �I��1 ) Address of mortgagee or contract seller(number and street.city,state.and ZIP code) Name of assignee or other owner or holder of mortgage MAY 8 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? Ha s ed If yes,state amount of deduction other county �c . in Indiana? ❑Yes B No GI'-'.2 t h5.Deb 1O A person is not entitled to this deduction unless the person has a balance on the persons mortgage or contract inmess 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' the mount of: I 20 0 20 cr 20 20 20 20 I Signature , ,Signature of County dito ern ounry Date( t da . ear) I/We certify under the penalty of perjury that the above and foregoing information i tr a and correct and that the applican is a re dint of Indiana and owner/contract buyer of the aforementioned property on date a pli tion is filetl/� Sg�A (ocmehfugname) //�� � � � � �/�' ^-- Date( nth.dayyear)/� P. 91 On r4 (]�QYy� / rV^^ / A11- Full resident address of applicant(number and street,city,state,and e a©a IAI • /Hi r-d 9. )) 1-1-A7ae n 5-n] u7 (24O Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 I 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$10.000.