HomeMy WebLinkAboutMortgage_Hunter (2) yr-v,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATIONestt
�1�5� O) .
State Form 43709(R 13/10-15) 1 _ 201.9
Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be filed in person or by mail. Form feed 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 .d 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)
Taxing -Si .
District Keynumber/le al description Kicky Lie � "e-c )9 P Reco9c1 Alumber Page number
D(v _ n- o\ - 4ok -op . 3g3- oaa 14-91355
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment dam,current year date of application legal or equitable owner?
( Q Op U/i (..I D. QC) [' 'Yes ❑ 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
[lt-Real Property ❑ Annually Assessed
Motile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
heck -Fecft1nA CrA vino s x�k of iv ansvi I k C
Address of mortgagee or contract seller(number an reet.city,state,and ZIP code) FI L E J
Name of assignee or other owner or holder of mortgage
JUN 1 4 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 deduction been req If mevrtt-of deduction
other county �-y on roe for
in Indiana? ❑Yes 1 No current year? ❑34$$ T
A person is not entitled t is deduction unl the person has a balance on the person's mortgage or contract indebtedness ess that isM 'cQ&1 the county
recorder's office(includi g a home equity n of credit that is recorded in the county recorder's office)that is the basis for the deduction.
ir\
UDITOR Deduction approved in the u f: U nen /20 20 20 3� 20 20 20
Signature of County Auditor Court (month,day.year)
;os� Date 6 - \k—ACIt
I/We certify under the penalty of perjury that the above and foregoing informa. is true and correct and that the applicant is a resident of Indiana and
owner/contr ct buyer of the aforem boned property on dat application is filed.
Signatu (otyae lull name Date month./y=yea2ioQ l r/ (l
Full r itlent ad of a iwnt(mum a and sheet city,slate.a ZIP code)
03 y executed LP . ) cn�-Pnsv i l( C i I� qi(o 1Q S _
Person authorizedby du Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day.year)
Address of authorized person (number and street.city,state,and ZIP code)