HomeMy WebLinkAboutMortgage_Spindler (8) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
,% FOR DEDUCTION FROM ASSESSED VALUATION
. c,'" ,, State Form 43709(R13/10-15) G QV\ • U.P.1101 • 2-0I Cl
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` %? Prescribed by Department of Local Government Finance
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File Mark
INSTRUCTIONS:
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 till 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 properly 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.
Applica t(owner or n ct buyer-see restrictions cry reverse side)
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Taxin District Key number/le des ption Record number Page number
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Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application CPO legal or itable owner?
6164/5Oo. Yes ElNo
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 differentthan that of applicant,indicate below. I e property in question:Annually Assessed
Real Property 0 Annually Assessed
' Mobile Home(IC 6-1.1 7)
Name of mortgagee or gontractr e�1Ve FILED,
Address of mortgagee oorrccoonptract seller(nuTnber and street city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage N O V 0 6 2019
Address of assignee(number and street,city,state,and ZIP code)
R (�P4 ,COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been rJ es d' i yes,state amount of deduction
other county on property for
in Indiana? Yes 0 No current year?
El 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 recorder's office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of. -
20 2 20 20 20 ' 20• 20
Signature of County Auditor County Date(mo hd ,latt
I/We certify under the pe Ity of perjury that the above and foregoing information is true and correct and that the applicant i a r ident of Indiana and
owne--r��/contract buyer of the aforementioned property on date application is filed. _
tSignatureT(o er'sfullname) Date,(montir,.day,year)!
Full rest ent address of applicant(number an. '-et city,state,and ZIP code) l'1463 c
ct31 r s c. like i - t�,—if)
Person authorized by duly executed Power Attomeyr by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street;city,state,and ZIP code)
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