HomeMy WebLinkAboutMortgage_Elliott (5) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS r_ICounty ; Township 1 Year
/44-iir41% FOR DEDUCTION FROM ASSESSED VALUATION 1
Sete Form 43709(R14/1-2th I Gibson 02-4.____i 2020
--.-.. .7.7, Prescribed tay Department of Local Government Finance
File Mark
INSTRUCTIONS To be flied in person or by mail. Fct'-O.' tn
air;
Filing Date Form 177LISt be completed and dated in trio calendar year for v.'hich the deduction is sought 1
1 COU'ity Auditor
Must be filed or postmarked with the County Auditor or
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Assesseo VaILIE,rs ree p-osert, as or I Mort:cage i Contract indebtedness usica c as o ,Mo.---s/Contrsitt in-'ebts-iirsits u-- -;sit 0 Is ' 'aep nso-i-i—--
assess-en,date cermet year I asseSsnient date current year ;lege or equit ote psiner? i
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I Yes E No
if rn v. <-.'17'in7---1;,e!he exact sba-e 0'interest'? i I'cs...ried,vri b someone otaitan spodse indicate witn whorl ----
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-If r 27-1,..1 6';-r)'.7.0,- is d Sereet tban that M add;cant ir dicate beg)x- tbs• opera,in sae:Magni Arindatiy Assessed ____
1 '-_,Rea'Property LI Annually Assessed ,
Mobile Horne(IC 6-1.1-7)
FILED
F iitlt-it-37rit,;:,:b77-i:-,--age-cre;ort-biamia s ;ler
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t ‘thccital-C-Lie at;j11/7446‘;*141'j-
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INNVI-te LA R. 0E4 .L(...„.TO I
1 71-6 50/ ,:7t,SON COUP AUDITOR
\,..hp. Taxing D c ;Has tin deduction been squested i If yes state arno_Int o de-No-Teri- -1
I on property for i- Li ;No 1
;current year? ; Yes
s a balance on the persons mortgage r contract indebtedness that is recorded in the county
is recorded in the county recorder's office) that is the basis for the deduction
COUNTY AUDITOR
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Signe:eta°MT iia,\;0%,1„........
•-- ;Cca_,rty -A
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' I I We certify under the penalty of perjury trir,tne above and foregoing information is tru d correct and that the appl cant is a read nt of Ind,ana and
• o.^iner/contract buyer of the aforementioned property on date application is filed
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—--— Date(month slay year)
F-45eci;-)-atbor•zel by del)/sxecht-a pcjt, of Att,,,,y or by iC,6-1 1-12-0,t i Date( nth day year,
1 .
7 keisr-eaSSof aut,mized persob (rt.. :,.r and street coy stale and ZIP cedei
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