HomeMy WebLinkAboutMortgage_Investments „,�,en4Tea STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear
FOR DEDUCTION FROM ASSESSED VALUATION
'''' '1' -t'i� State Form 43709(R14/1-20) q S k O a , 20 2-0
s Prescribed by Department of Local Government Finance _
File Mark
INSTRUCTIONS: To be filed in person or by maiL
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. K County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is
located on or before January 5 of the calendar year in which the property taxes are first due and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications. '
Applicant(owiprc.,%ractbu er-Is coons on rev se side)
Taxin t' Key nu berI lega descrption Record number Page numb
- - te oa a.9�,�=off 2-0 7.0 419
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indeb dness unpaid as of Is the appli nt the sole
assessment date,current year assessment date,current year date of application legal.or a 'table owner?
f639 ` Yes ❑No
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 different than that of applicant,indicate below: Is t, property in question:Annually Assessed
r1 -yp•-..'1.-
erty ❑Annually Assessed •
' /�• Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract s er a � � ��”' V
Address of mortgagee or contra seller(numbed stye ,city,state,a IP code) -
VV SEP1 pp-
Name of assignee or other owner or holder of mortgage _ nn 2020
Address of assignee(number andGIE3 /�frl
g..6.- -) SSA!CL,UAITY Does applicant own property in ar Drawer NOis this deductiori been requested If yes,atatViraik*deduction
other county ❑Yes ❑N .property for
in Indiana? rrent year? ❑Yes ❑No
•
•
Ca r r�
A person is not entitled to this �1�� tortgage or contract indebtedness that is recorded in the county
recorder's office(including anj ' rder's office)that is the basis for the deduction.
Deduction approved in the amour,,.,,.
20 20 20 20 20 20 20,
Signature ty Auditor County Date(month,day,year)
/We certify under the penalty of perjury tKaftflrs 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.
Signature,(owner's full me) Date(m th,day, ea
Full resident address of a plica (number and stre ity,state,and ZIP co
P�/ F Alol �i �' Mrlvc-ery 6,0
Person authorized by duly executed Pow 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)
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