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HomeMy WebLinkAboutMortgage_Robeson (2) .50_I4t- STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year V4 t FOR DEDUCTION FROM ASSESSED VALUATION \ �n State Form 43709(R14/1-20) ��� (' { C_ o :?, Prescribed by Department of Local Government Finance ` J�/ \ 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. Applicant! ner or contract b r_-s e restricts on everse side) 1 O' '&�� ��1 �i e5-�0 r) Taxing Distil FCy ymb-r -b description n 1 -0°O '5,��•© 0^ Renumber Page�m¢gr y— Assessed\\value of real property as of Z 6 Mortgage/Contract indebtedness unpaid as of Mort age/C tralctt indebtedness unpaid assoof`�Is the applicant th`e�sollee assessment date,current year assessment date,current year date o ti anon -o legal or egyitable owner? Yes ❑No If no,what is his/her exact share of interest? If owned wit sorleone otlttr than spouse,indicate with whom If name on record is different than that of applicant,indicate below: Is e property in question:Annually Assessed �T Real Property ❑Annually Assessed L Mobile Home(IC 6-1.1-7) Name ortgage or contract s Address of of m contract sell r(number a d s et,cistate,and ZIP code) MIG 5 2027 Name of assinnee or other owner or holder of mortgage Address of a0aa.- a "f . S Gt�NCOtINTY A Does app11 �07 Li/, -L District? Has this deductio b en requested If yes,state amount of deduction other courrlt on property for in Indiana c/) current year? Yes CI No A person f� +, (�r �O on the person's mortgage or ont ct indebtedness that is recorded in the county recorder' t -[ in the county recorder's office)that is the basis for the deduction. w w UNTY AUDITOR Deduction e1 20 20 20 20 20 20 20 Signature of County Auditor ) County \ Oa "' nt ay,year I/We certify under the penalty of �v that the above and foregoing information is tr and correct and that the applican Isar sident of Indiana and owner/contract buyer of the aforementioned property on date application is filed. XSignatur `(pfwnneer'ss full name) Date(month,day,year) Full resent actr of applicant(number a d scree city,state,and ZIP code) Person authorized by duly executetl Power of Attorney 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) — --. ...__`_- ;...+ ;.........,........s...................,.s...u....__..-.-.,...-.:_.--.s... .a tin nnn