HomeMy WebLinkAboutMortgage_Barnerd �,� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
t FOR DEDUCTION FROM ASSESSED VALUATION \
State Form 43709(R13/10-15) �' r\ rt y , 24\61
`-- Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Math
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 rrr���ttt
Must be filed orposimarked with the County Auditor or County Recorder of the county whem the property is County Auditor
located on or before January 5 of the irmrndiately succeeding calendar year. County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must We 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 Guyer- on reverse see
3- 6C-C �•-i} S t.n� otvntAA
Taxing District �.1 Key number/legal description Record number Paag number
26-kq-la- 2o3 -ooI .230\ -c02G 1 `1]7 .
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage Contract indebtedness un as of Is the applicant the sole
assessment date,current year assessment dale,current year date of a plica'.gn ^ ^ O j legal o{r�ecpuitatia ovmeR
,"i1\ rlJl'r�/1I Yes ❑ No
If no,what is his I her exact share of interest? If owned with ne other tharispouse,indicate with whom /
If name on record is different than that of applicant,indicate below. Is property in question:Annually Assessed
Real Property ❑ Annually Assessed
Mobile Home(IC&-1.1-7)
Name of mortgagee orconbactgejpr 1V
J �JY1 ‘&
i
Address of mortgagee or contract seller(number and street city,state,and ZIP code) �� i, '
Name of assignee or other owner or holder of mortgage AAA AUG 1 5 2019
Address of assignee(number and street city,state,and ZIP code)
•
Does applicant awn property in any If yes,what county? What Taxing District? Has this de hr u �e?cll � �5fa a amount of deduction
d county
❑ e,.ai
in Indiana? Yes ❑No arrant Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the persons mortgage or contract indebtedness that is recorded in the county
recorders 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 a oved in the amount of
20 20 < 2Q
20 20 20' 20
signaNre of 44(
r 20 County 0' 0,7 d
I/We certify under the penalty of perjury that me above and foregoing infonna true and correct and that the applicantres ent of Indiana and
_ er/contract buyer of the aforementionedproperty on date application is filet bpi
s re(T/4%`n�VAVI 0 fh4,i;ar) .
Fu nt/I^Idrr/elsss;%.of a fxant(number ay,state,and ZIP code)
Person authorized by duty executed 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)
•
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000. ..