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HomeMy WebLinkAboutMortgage_Lyons (2) ,..—•.,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ounty Township_ _ Year / FOR DEDUCTION FROM ASSESSED VALUATION ��� © n �2 State Form 43709(R14/1-20) G ',`�- '' 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 Ov- LJ /Ppvl� 1 Taxing Distr t Key nu r/legal description Record number Page number O `Z 26 - C1- \2- 2.0[-1 O GO. IcAT- 02z ` ..p 22_ Zs-Z2 Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applic nt the sole assessment date,current year assessment date,current year date f pplCion 17.0 legal or rtable owner? 'll / Yes El No o If no,what is his/her exact share of interest? If owned with m one otiSer than spotise,indicate with whom If name on record is different than that of applicant,indicate below: ' t e property in question:Annually Assessed Real Property ❑Annually Assessed Mobile Home(IC 6-1.1-7) Name ortgag or contras seller Addres o ortgagee or co t s ter ub- s eet i� 26,2 A ' Drawer NO Name of assignee or other owner or holder of mortgage JUL 2 9 2022 7� 2 Address of assignee(number and street,city,state,and ZIP. Cat ' 1�T O Does applicant own proper yaah8t E What Taxing District? Has this deducti b n requested If yes,state amount of deduction other county COUNTY AUt�1 TOR on property for in Indiana? ❑Yes G current year? Yes ❑No A person is not entitled to this deduction unless the person has a balance on the person's mortgage or o ract 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: 20 20 20 20 20 20 20 413 Signal of �:p�unjtyn\,udi ,63 County 1 Date( ,day, arr)) 2_I I We certify under the penalty of perjury that the above and foregoing information is tr and correct and that the applicant is reside t of Indiana and owner I contract buyer of the aforementioned property on date application is filed. ow ull n e) Si nature Date(mo hy,yr) 9 [[// ('�l Full ident add ss of app ca (n mbd street,icity state, ZIP code) 2 a VI Person authorized by duly e4cuted Power of orney 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) The penalties for oeriury can include imprisonment nn In twn and a half.,ears anti a fin..,.,...,. P+^^^^