HomeMy WebLinkAboutMortgage_Kroeger (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
7%t��RR •e FOR DEDUCTION FROM ASSESSED VALUATION 1 C�
\ ._,,,s State Form 43709(R14/1-20) I�,.J�, �r�I`(„Pi�� ��
-• 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. U.-"C,ounty Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is County Recorder
located on or before January 5 of the calendar
.�J��J�(`S3/4.6ecRo r_\ KrO ie.
Keynumber/legal description Record number Page number
Taxing District 2 • OS I D o�K a )c - / ! i t
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year datygf application legal or equitable owner?
assessment date,current year 'Sh'OOb li'Yes ElNo
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
Is the property in question:Annually Assessed
If name on record is different than that of applicant,indicate below: [l'Freal Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
� FILED�ofm MaN- otnfrA
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
Name of assignee or other owner or holder of mortgage 0 C T 2 5 2022
Address of assignee(number and street.city,state,and ZIP code) L _J, J///�����,�((����))
What TaxingDistrict? Has this deduction been f ey�,'+stdraffr(Wdeduction
Does applicant own property in any If yes,what county? on property for �,r IEM: COUNTY AUDITOR
other county ❑ LJ,� current year. I�'r G'_ `t.J���
in Indiana? Yes o -
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract 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:
1 20 20 20 20
20 20 20
County Date(month,day,year)
Signature of County Auditor 1 rt
I/We certi under the penalty of perju that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
ow -r I contr-.t buyer of the aforeme oned property on date application is filed. (Date(monr day,year
Signat - (o s .) n ' ` I D I �f_ �O2
Full resi.ent addr--s of appli•• ber and str e,c�tate,a d ZIP code) T^/ �� f/ LJ c '
-5 - o w b:rd [r �rince�N L 7 o
Person a- -•rized by duly executed Power f 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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.