HomeMy WebLinkAboutMortgage_Maikranz (10) ,A4-Tif?--,-.:4,. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS __County 1
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FOR DEDUCTION FROM ASSESSED VALUATION ! --
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\:714,44 ,,i ia,e Form 43709(R14/1-23) lo AlP1.-ez-v;1 e? -
Prescribed by Department of Local Government Finance Gibson-- I
File Mark
INSTRUCTIONS: To be fled in person or by mail.
property is County Auditor
located on or before January 5 of the calendar year in which the property taxes are first due and payable. D County Recorder
See reverse side for additional instructions and qualifications.
Applicant(oche'or contraut buyer-see restrictions on reverse side) .„ . . _____...........___
• __)OA h uix., .)-1 Ki- 3.e65, Ca_. _114°4.„....1.j'Cra'12-•
Taxino District Key number/legal description j Record number Page number ----
• 603 icr: l6-c).(2-002-y•o - oeo-- 3 7,3 -0.0 3 1 0 i 1 0 5 57
-- •
Assessed value ot real property as of Mortgage/Contract indebtedness unpaid.as of I Mortgage/Contrast indebtedness unpaid as of Is the applicant the sole •-•-•-•
assessment date, current year assessment date current year I date of application lega'or equitable owner?
q 001:7 ,
--1-ITOWniedIwith someone other than spouse indicate with whom 0-Y-6*--S [..-j No
If no.what is his/her exact share of interest? •"-----
1 I
:If name on-record is different than that of applicant.indicate below, Is,....:tii..„-ita...prii<erty in question,Annually Assessed
E Real Property E Annually Assessed
Mobile Home(IC 6-1.1-7),
NTh;'.7i---of rro7tgagee or contract seller i
i C9 errviool AmeliCatA
0 _.i Pidre-i-ss of mortgeoee or contract seller(nut-niter and street.cit; D r a-sx e r NO
1
(7,___ FILED
C
,„,.i-If assignee or other ov.mer or holder of mortg-a-q-e;-
-71--
F.Arici.-e:F;s-Of assignee(rurnbor arid street.city)state deaZtP ccc
DEC 2 9 2021
1:5Oesapplicant own piaped,/in any If yes v.:hat county? T,,,,hat Taxing f:57.-s-i-C-t-5— Iliad---TGs7- do torc n request If yes sate amount of deduLAn I
other county cur
I ,--,yes r..j.,-4.,<:; I on prope y for .144444.46)in_Indiiiana? 1 rent ear? I: ,_
L-l_ --1 .
A person is not entitled to this deduction unless the person has a balance on the person's mod go or c ntra in tasseceocartiivdalyorrocu'un-ty— -'
recorder's office(including any home equity line of credit that is recorded in the county recorder offic that i basis for the deduction.
COUNTY AUDITOR
ID,,,d6,-,t;o,apPMOT,ect in the a rniont of !
,
20 I 20 i
I 20
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i 20 20 I 20 i
20 --1
,....._ I
I ______ ! I
Signature or Coiyi,ty Auditor . 1 County Date(month day year)
_ _
1/\j6j- ------ IV '
('; f h 5 c..).,-7 (/''''',= . 70- /
____ _ I
We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a rex-dent of Indiana and I
owner/contract buyer of the aforementioned property on date application is filed. I
src,1:-,2,%J,rox/rier'STrrirI riaMej ,@rosin day year)
74 ___- q
-----„,re-sTdent aci-drieST;of applicant(number a,d street cey state cid irP codeT
St- 6 c,Pciewd C_,_.`Lf._ , ,. -_.„,.,.,.._W__. L2-17_&.1t_t) ,
Person aothorized by duly executed Power or Attorney'or by ICC-1.1-12-0 7 I Date(month.day year)
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______._„..„„.._„ ................___....E...._.......
Address oleuthierized persoT. (number and street.city stare.and ZIP cede.)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S/0,000.