HomeMy WebLinkAboutMortgage_Bruce (13) <E"•4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
b FOR DEDUCTION FROM ASSESSED VALUATION l y� rL,
/• State Form 43709(R14/1-20) ion (' )2� �r/=0
s'' Prescribed by Department of Local Government Finance 1 �/
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
cl_ k 6. cut_c_.2_ 41/71
axing District mber/legal description Record number Pa a number
029 - --R.-16- iOl^000. - ^Cf- . 20).- 621
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtel�ess un d as of Is the appli t the sole
assessment date,current year assessment date,current year date of ap Contract
is—. J f7 legal ore !table owner?
(�` f0(� Yes ❑No
If no,what is his/her exact share of interest? If owned with someo a other tha)spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is he roperty in question:Annually Assessed
eal Property ID Annually Assessed
! Mobile Home(IC 6-1.1-7)
Name of mortg ntraellarrg1 (� J j
CAN3 1•‘ dlk ._ F
Address of mortgagee or contract seller(number and street, . ,state,and IP code) �
Name of assignee or other owner or holder of mortgage N O V 1 ®t� 2020
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any If yes,what county? What Taxing District? 114$f$( 4.uuW. t1 Fetfucteli)T If(ygkstate amount of deduction
other nty Li ❑No Yes El on property for No
in Indianacou. current year?
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or c nt ct 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 ;'I 20 20 20 20 20 20
Signature of Coun A !tor , \ County Date 7Ih
,day,year)IIII 1 i I I C 4._J . i . --VP ell°
I/We certify u ier 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.
�S'gnatu wners full name Date(month,day,year)
_� /14,1,14,i2,,,, 6 - 1I- n- ` ,o t/i .
Fu I sident address of applicant(number and eel,city,state,an ZIP c e}
OW I 1 ins4a r ��; � � ,�� �c�c�� c�
rson 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)