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HomeMy WebLinkAboutMortgage_Morgan (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year t�.•= FOR DEDUCTION FROM ASSESSED VALUATION �=' - State Form 43709(R13/10-15)r- T (� ? Prescribed by Department of Local Government Finance • 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 :1 County Auditor located on or before January 5 of the immediately succeeding calendar year. I♦, 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. Applicantowner o`contract r-seerestrictions on reverse side) NN\rJ w -4 g District �K/�numbs gaindescription ; - iE. .0 R d n umb Pa ner Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortg-•e I Contract indebtedness maid as of Is the applicant the sole assessment date,current year assessment date,current year �;�s •pica ^ o,.^v— legal e 'table owner? JAN 0 �' � tpj ifVl V • Yes 0 No If no,what is his/her exact share of interest? If owned wi; omeene.othir than spouse,indicate with whom If name on record is different than that of applicant,indicate below: i Ll Sri`'"CO- ��3 i yi AUDITOR I e property in question:Annually Assessed Real Property 0 Annually Assessed • _ • Mobile Home(IC 6-1.1-7) Name of ages orcontpct seller, 1 - :_.-.._ :_ �_ :W:____.—.,.,__.--.---- Address of mortgagee or contract seller(number and sl Drawer NO Name of assignee or other owner or holder of mortgage Address of assignee(number and sheet,city,state,anc Card NO. Does applicant own property in any If yes.what coun requested If yes,state amount of deduction other county in Indiana? ❑Yes ❑No i I eulrenr year! u res ❑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 20 20 20 • 20 20' 20 re Qf my Audit County Date(month day, ear) I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and owner/contract buyer of the aforementioned property on date application is filed. ASignature(owner's full name) Date(month,day_vear) TE h 01. Os 2: . Full resident address of applicant(number and street,city,state,and ZI code) oat�g E S ©Gk,4n On'� 6 6 v Person authorized by duly 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.