HomeMy WebLinkAboutMortgage_Hutchinson�° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�`-° ' FOR DEDUCTION FROM ASSESSED VALUATION Cou wnshi Year
S / State Fofm a3709 (R4 / 10.07)
�M.PrescribeC by Department ol Laal Govemment Finance
MAY 3 2002
INSTRUCTIONS: File M��i.�
�/
To be filed in person or by mail with the County Auditor o/ the county where the property is located.
Filing Dafes: 1) Real Property: During fhe 12 months belore May 11 0/ the yea� the deducfion is to be '.
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 0( lhe yearfli��dilaGilNy'�'fo�A�h7t�Sti e.
See reverse side for additional instructions and quali�ca6ons.
Applicant
buyer- see restrictions an
Assessed value of real property as of
March 1, wrrent year
If no, what is his / her exact share of interest?
Key number / legal
Record number �
QD) _ oO�(� ^ ` Page number � ` �
.�' t.XJ ��
Mortgage / Contrad indebtedness unpaid as of Is the applicanf the sole legal or equitable
March 1, wrrent year owneR ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
I �1"v -
If name on record is different Ihan lhat of applicant, indicate below:
�ne of mortgagee or contrad seller ��� ^
��
Address ot mortgagee or contred seller (num er and st2et, city, stafe, ZIP
Name of assignee or other owner or holder of mortgage
of assignee (number and sVeet, city, state, ZIP code)
�QO - D00. �9 G2'�/
Is ihe property in question
Does applicant own property in any other If yes, what wunty? I What Taxing Distrid?
county in Indiana?
COUNTY AUDITOR
approved in fhe amount of:
�a� �
_ zoQ3 zo�� zo 20
�s � '
County AudRor
❑ Real Properly ❑ Mobile Horrie QC 61.1-�
Has this dedudion been requested on
property for current yeaf? � Yes ❑ No
zo
Date
zo �_
�
certify under the penalty of perjury lhat lhe above and foregoing information is true and corred and ihat the applicants was / were
lent of Indiana and owner of lhe aforementioned property on March t, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of aulhorized person