HomeMy WebLinkAboutMortgage_Barrett (7) 7:7 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou tTownship
�.. iy Year
��--�� FOR DEDUCTION FROM ASSESSED VALUATION
``�,1,1
,,,, State Form 43709(R13/10-15) IL. 1D N
.\;,111--< Prescribed by Department of Local Government Finance
�me
INSTRUCTIONS: MAR 10 2020 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 wh the pro ert • ❑ 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 gpgrg d � ��TO R
where the ro ert is located duringthe twelve 12 months before March 31 of e t e / n s sou
See reverse side for additional instructions and qualifications. AAppliran�(owner or coLdract buyer-see re 'ction r ve a
cid
,,,,,,,_
Taxi District Ke number/legal description Record number Page number
a C. Adit/- � - 300 - 00/. y5(a - o�,�{ �o 3 0 a---
Ass sed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
ass ssment date,current year assessment date,current year date of application legal or equitable owner?
193 0Oa ❑ Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other(han spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
❑ Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee o ntract s let � �� ,
Address of mortgagee or contract seller(n�ber and street,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) ^
Does applicant own property in any If yes,what county? What Taxing District? Has tl ...,0.
other county on pri
in Indiana? ❑Yes ❑No curre Card r •
A person is not entitled to this deduction unless the person has a balance on the person's mo 1 o. .,, ��
recorder's office(including any home equity line of credit that is recorded in the county recorc ........
COUNTY AUDITOR _
. . Deduction approved in the amount of:
20 20 20 20 20 20 20
Signat a of County Auditor / County Date(month,day,year)
I/We certify under the penalty of perjury that the abo 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.
Si nag tuts(owner's full name1 _ Date(month,day,year)
X (Full resident address appkaannt(number and street,city,state,and ZIP co e)
1 as-91-1 S siue40\ 'mac-, \ c, 6. cdVA J-17(0:f)
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 nenaltiec inr npriiint ran include imnricnnmeni un tn kiln anti a half vevc anti a fine nnf fn evreetl Tin nnn