HomeMy WebLinkAboutMortgage_Ridgely �s 7 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
'' State Form 43709(R13I 10-15)
<-•--- Prescribed by Department of Local Government Finance
INSTRUCTIONS: • File Mark
To be filed in person or by mail. Fenn filed with:
Filing Oates 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 properly is 0 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 noun ❑aunty Recorder
where the property is located during the twelve(12)months befom March 31 of each year the dedu ' r
See reverse side for additional instructions and qualifications. 1NY►.�'
(owner croon d r-see re k4Aa. on reverse side) ��ff 11��11 qq AA
T rstria lAs/ A Key n /legal description Recgaki A ieT 2U Page number
101d ( 04,14-/a- � 335 W7 aovt _VS12_
Assessed value of real property Mortgage/Contract ind edness unpaid as of Mortgage/Contract indebtedness un or nt the sole
assessmentassessment date,current year assessmentdate,anent year of application Ter?
,I87159 3 G(nSON COUNTY es ❑ No
If no,what is his I 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 belay. Is the in question:Annually Assessed
Property 0 AnnuaflyAssessed
• Mobile Home(IC 6-1.1-7)
•
Name mortgagee or contract seller Cited
)r L
C I M -taLA La e: �D /U t7L--
Address of mortgagee or contract seller(number and street,city,state.and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street city,state,and ZIP code)
rope
Doers county applicant own properly in any what county? What Taxing District? Hasp riled been requested If yes,state amount of deduction
othin Indiana? ❑Yes o current year?for ❑Yes 0 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 recorders office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of
20 20 20 20 20 ' 20' 20
S"gnatu of unry Auditgr 4 Courty��/p-A Date(month,day,year)
II We certify under the penalty of perjury that the abovhd foregoing information is true and correct and that the applicant is a resident of Indiana and
owner!contract buyer of the aforementioned property date application is filed.Xs ie(avnerk e) � Date q+(�+o)mh day, /
2 of mk� L code) n T� �c&O
Person authorized Imesi by duly executed Power of Atom4 or by IC 6i1.1-12-0.7 J Date(month,day,year)
Address of autlwrized 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 S 10,000. .