HomeMy WebLinkAboutMortgage_Marsh (2) .MEN, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownship
o�/ ,,A-,.-� - Year
, _ ;:1 FOR-'DEDUCTION FROM-ASSESSED-VALUATION ��O�
"` `.' �/' State Form 43709(R13/10-15) GIBSON `��w
-- Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail. Fo m 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 County Auditor
located on or before January 5 of the immediatelysucceeding calendar yeas ❑ ounty 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.
ApCpant owner or contract bu er-see restriction revers side
Taxing District Key numbe /legal descri i n Record number Page number
2(o -- D S-3\ 20� ^oOO C I- 3q Lt I_
Assessed value of real property as of ' Mortgage/Contract indebtedness unpaid as of Mortgage Contract indebtedness unpajti s of Is the applicant the sole
assessment date,current year assessment date,current year • • ., date of Iic4ti j ` .Lk) legal o. quitable owner?
I` U( I ] Yes ❑ No
If no,what is his/her exact share of.interest? If owned with som' ne other thin spouse,indicate with whom J 1
If name on record is different than that of applicant,indicate below: a property in question:Annually Assessed
Real Property ❑ AnnuallyAssessed .,
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller .
CAFIKIL
r,i 4
Address of mortgagee or contract seller(nu ber and street,city,state,and ZIP code) �i��'�1�
� }-,L .
Name of assignee oro 02_.0-02.0 — 3 V- 7
-AUG 1 2 2020 .
Address of assignee(n Drawer NO
Does applicant own prc T Has this ecc{{yy ' , f
other county Card N O• on`proi slsegb + roes' .t �094:PetVamount of deduction
in Indiana? Ye. current year? •
❑ Yes ❑No _
A person is not entitle person's mortgage or contract indebtedness thatis,recorded in the county
recorder's office(incluoing 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 0 9 20 20 20 20
Signature of C u 'tor County Date(mo d y,year)
s `i`'` 17_
I I We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a r sident f Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signat nee full na ) Date mont
•
y ) 2JZ �
Ful e I ddr f a pt(pumbe street,Ate state,and ZI-P pod ,(� ) ^ , _ �^ (�
Person authorized by duly executedute`d Power of Attorney or y I 6-1.1-12-0.7�` ) Y`' J Date(month,day,year)
Address of authorized person (number and street,city,state,and ZIP code) -
The nenaltiec_fnr _^an inrlurle imnrignnmant tin in fwn and a half vaarc anrf a find not in Avroarl TIn nM