HomeMy WebLinkAboutMortgage_Hilld�a�p4� STATEMENT OF�MORTGAGE OR CONTRACT
:�. INDEBTEDNESS�FOR DEDUCTION FROM ASSESSED
� VALUATION State Form 43709 (1-90) Prescribed by the
'� ���• ' State Board of Tax Commissioners
�'
Iristructions for filing:
To be filed in person or by mail with the County Auditor of the county ��here the
property is located during the 12 months before May 11 of ihe year the deduction
is to be effective. See reverse for additional instructions and qualifications.
Filin fee $1.00
� Township
SEP 14- 1998
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GIB.°,^vi�C�U•��•� pIIDiTOR 1
ppli ant Owner or t u er -�se r stric ons on r erse)
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Taxing District Key Number/Legal Description Record No.
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Page No. �
Assessed value of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as of At�dch 1, current year. equitable owner? O yes ❑ no
`�,�3 5 �
If no, what is his/her exact share or interest? If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
�Name of mortgagee o contract seller � �
Address �f mortgagee or contract seller �
Name of Assignee or other owner or holder of Mortgage.
Address of Assignee
Does applicant own real property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
year? ❑ yes ❑ no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19��0(� 19_ .,6{1 � 19� �% ��Q3_ � 19�
�IR s �- _a - ��z �
Sig�ature Secretary of Board of Review Date 6��1�9 O 1 1
0
IlWe certify under penalty of perjury that the above and foregoing information is true and correci and that the �ppli-
,nts was/were a resident of Indiana and owner of the aforementioned property on March 1, 19 �
�,g owners fuli�a n� Person authorized by duly executed Power of Attorney or
. �,,��y- � J by IC 6-1.1-12-.07).
u�l Resident Address of Aplicant — Address of Authorized Person
` `� o� �(z- f�.p ��N���1 e � �I-7h� �.-�.