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HomeMy WebLinkAboutMortgage_Benson (2) „E.7, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESSCountyTownship -;�4 Year FOR DEDUCTION FROM ASSESSED VALUATION <;; (R14 ) \ (�2f ?.0 , - '> State Form 43709 /1-20 /;, Jy\ .b<" i” . „gym 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. 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�firgst due and payable. County Recorder See reverse side for additional instructions and qualifications. Taxing District Ke umber/legal description Record number Page number O21 2C-1 -7-29t -- Zoc - 000 - T60 -02-1 . 20 1 s ._2 cm Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole assessment date,current year assessment date,current year date of a igat_ion 0" © ,^ legal or q table owner? IU,/ U Yes No If no,what is his/her exact share of interest? If owned with som one othdr than spouse,indicate with whom If name on record is different than that of applicant,indicate below: I e property in question:Annually Assessed Real Property ❑Annually Assessed � Mobile Home(IC 6-1.1-7) Name of mortgagee or cont t seller c-- _/ . -fify) Address of mortgagee or contract se ler(number and< street,city,state,and ZIP code) V _..---IL Name of assignee or other owner or holder of mortgage tt Address of assignee(number and street,city,state,and ZIP code) NQ V 16 2020 Does applicant own property in any If yes,what county? What Taxing District? Has this deducti 1r` en -v --1-iP • If ye ,AWe amount of deduction 4t other county on property for ,f\ up"1 in Indiana? Ill Yes ❑No current year? UUI A person is not entitled to this deduction unless the person has a balance on the person's mort ontract 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 ' V I f n CD County \ Date(mpnth day,yea I/We certify under the penalty of perjury that the above and foregoing information i t e and correct and that the applicant is a esident of Indiana and owner/contract buyer of the aforementioned property on date application is filed. xSturocsfInarne Date(non dayear) F si ress of a licant(�u�ber and street city st and ZIP code) 11 �a l� s �`� e '-On -49- GG.�� 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)