HomeMy WebLinkAboutMortgage_Hudson (5) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
`\ FOR DEDUCTION FROM ASSESSED VALUATION ( `Z�
a(\ State Form 43709(R14/1-20) G s oV\ 02�
--.r 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. County Auditor
Must be filed or postmarked with the County Auditor or County
Appli t own r or contract buyer
r`j- eee r s`t�riccttions on reverse side)
Taxing strict Key number/legal description ��� Record number Page num3ber '1
rjta_
26- t2-e6-t00-000 _ `f— ')-0 - l/Q
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortga /Contract indebtedness unpaid as of Is legaltory li t the sole
table owner?
assessment date,current year assessment date,current year date of pylon ^ q
01 Yes ❑No
If no,what is his/her exact share of interest? If owned with s eone othe then spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is e property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of m a ee or contract eller LT cc L,{
Address of mortgagee or contract seller(number an
9017
D FILED
Name of assignee or other owner or holder of mortg
Card NO. I 4,93/
Address of assignee(number and street,city,state,
MAY 6 2022
4 A'1,Goo
Does applicant own property in any If yes,what c__...,. mrie urstnct r I Has this deduction en requested If es,state amount of deduction
other county on property fo d)
in Indiana? Lives ❑No I..,.a, ra current year? s
A person is not entitled to this deduction unless the person has a balance on the person's mortgage o StPhibil AM 144orded 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 c........-- 20 20 20 20 20
Signature f Corl'o 20 rIA
County t V C� Date(month, ye r),...7 7-1^
C
I/We rtify under the penalty of perjury that the above and foregoing information is true a d correct and that the applicant i esi a of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Date(month,day,year)
Signature(owner's full name)
\KoC^`
Full resident address
off applican (number and street,city,state,and ZIP code)
1 k{1 S I V �� Date(month,day,year)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
Address of authorized person (number and street,city,state,and ZIP code)
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