HomeMy WebLinkAboutMortgage_Atkins�iai � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
! State Form 43709 (R615-O6)
.� �� Prescribed by Depanment of Loral Govemment Finance
�
�
C unt Township Year
. �
DEC 4
INSTRUCTIONS: File M�?It'�
To be filed in person or by mail with the County Auditor o/ the county whe�e the property is located. `�,
Filing Dates: 1) Real Property: Dunng the 12 months belore June I f o/ the year the deduction is fo be elfect'F%.� �
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the y��g�¢���,�,s�I1QEf(ective.
UITOR
See �everse side for additional instnictions and quali/rcations. '
Applicant
Taxing
- see re t' ns on reve� side) ,
o `
l
= Key number / legal description
�r� - ��v -r �o
Assessed value of real properry as of
March 1, wrrent year
I( no, what is his / her exact share
- - i. L
Mortgage / Contract ir
March 1, current year
/Q /,
name on record is different than thaf of applicant,
Record number
Page number /� �
�
unpaid as of Is the applicant the sole legal or
owneR ❑ Yes ❑ No'
If owned with someone olher than spouse, indicate with whom.
e oi mortgagee or conVad seller
Address of mortgagee or contra� � O�D�� �- ---- _
� �3 �Z .,y_,
Name of assignee or other own ea,.M.-.�.� � C 7
Addreas
Does applicant own property
county in Indiana?
Deduction approved
20 ��
P
Signature
�o � y
- �/G' � oa ,
� ���s„� ig Distnc[?
� Fcy
��_
COUNTY AUDITOR
in the amount of:
20 � 9 20 20 20
P C'�
County Auditor
s the property in question:
� Real Property ❑ Modle Hmie pC 61.
Has this dedudion been requested on
property for wrtent yeaR � Yes� No
20
�
certify under the penalty of perjury lhat the above and foregoing infortnation is true and corred and thal the applicants was / were
lent of Indiana and owner of the aforementioned property on March 7, 20
ire (owner�I'lu0 n�e� ^ Person authorized by duly exewted Power of Attomey
'�A / / / // � �^ � or by IC 6-1.1-12-.07
Address of aulhorized person