HomeMy WebLinkAboutMortgage_Richardson (12) ----„�, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS un Township
d, �, q #y Year
T - s FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R14/1-20) LIZ
D
M -. Prescribed by Department of Local
( DEC 3 0 2020 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 t broperty's
located on or before January 5 of the calendar year in which the property taxes are fir a gt County Recorder
• 110660N CouNTy auD►ro
See reverse side for additional instructions and qualifications. R
Applica owner or contract buyer-see restrictions on reverse e)� _
• ,
Taxi istrict, ' Key number/legal description Record number Page number
a6 —ii -lA -II b`/-DD-I . 6O13 - O.1- $ f 4 5/;%
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 application ®® legal or equitable owner?
Oo0 ❑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 fiLspoperty in question:Annually Assessed
eal Property ❑Annually Assessed
i -',Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
E Tr6u
Address of mortgagee or contract seller(number and 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 this deduction been requested If yes,state amount of deduction'
other county on property for
in Indiana? ❑Yes N No current year? ['Yes'' •0-No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity fine 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 20 20 20 20 20 - • 20 `
Signature,of County Auditor ' ' •County ' . Date(month;day,year) •
1
I/We certify under the penalty of perjury that t 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 name) Date(month,day,year)
Full resident address of applicant(number and street,city,state,and ZIP code)
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)
A a,A nnn