HomeMy WebLinkAboutMortgage_Rowe (2) Aco„Yrici STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County J Township Year ____I
�...,
� .- { FOR DEDUCTION FROM ASSESSED VALUATION /�
i State Form 43709(R14/1-20) Gibson O O 6 2020
zi- 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. Z 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
number Page umber
'/`�'l /`(J\ ` 't0 —O cam\ �``� -('� 6 �.(^�
14
1'• •Assessed value of real property as of h1ort� e i Contract indebtedness unpaid as of Mortgage/Contract mdeedneas unpaid as of Is the a li nt the sole
assessment date.current year assessment date.current year d e of applic lion 0 NJ legal or itable owner?
I l f OD • Yes ❑No
If no.what is his/her exact share of interest? If owned♦citn someone other than spouse,indicate with whom
1•If name on record is different than that of applicant,indicate below: Is a property in question:Annually Assessed
1 eat Property ❑Annually Assessed
f: ��ILEA Mobile Home(IC 6-1.1-7)
'Name �grtgagee or co Ile
1 mortgagee or contract seller(number and street.city state.and ZIP code)F
Li Il2.2-
Name of assignee or other owner or holder of mortgage D` '�� ��
Address of assignee(number and street.city.state.and ZIP code)I AthI t i u.
LON C NTY AUDITOR
Does applicant own property in any If yes what county? What Taxing District? oHas n property deduction en requested If yes.state amount of deduction
other county ❑ �
in Indiana? ❑Yes El No current year? es No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or c ntr 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-
i
20 20 20 20 20 20 20
I;Signature
of Co • AA, County Date((nonlfi. .=y�ypa\ ^
1 I We certifyunder the pe Pr y that the above and foregoing information is true and correct and th- - ••licantt I - .enen o '•O- and
�
owner ontract buyer of the aforementioned property on date application is filed.
S gnat4.v -r's Il n,,.e) - ■;te(month,d }la e
XF II beside dre�a•of appli nt u(nbd streetfate.y,n�Zl��ode)
' Person authorized by duly executed Power of torney or t I 6-1.1-12-0 7 Date(month.day year)
Address of authorized person (number and street.city.state.and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed S/0,000.