HomeMy WebLinkAboutMortgage_McKinney (2)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
� FOR DEDUCTION FROM ASSESSED VALUATION
a N� � State Form 43709 (RS / a-03)
� PfescnDed by Department of Laal Govemment Finance
Coun Township Year
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INSTRUCTIONS: y` -- .Eile,Me- � /
To be (iled in person or 6y mail with the County Auditor o/ the county where the p�operty is located.
Filing Dates: 1) Real Property: During the 12 montAs before May 11 0/ the year the deduction is to be eflect/ ve� � L ti �
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 and March 2 0/ the year the deduction i�lo��e eNective.
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See reverse side for additional instructions and qualilcations. ti, ��,� [.�
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Applicant
Taxing District
Assessed value ofre:
March 1, current year
see
property as of
Key n�jmber / legal
Record number
iJ'� O /_O/��/� ,r,i1 IPagenumber
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Mortgage / Contrect indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, cur� Tyea1r �� ) OoO / ownef? ❑ Yes ❑ No
If no, what is his / her exad share of interest? � � If owned with someone other than spouse, indicate with whom.
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If name on record is different than lhat of appiicant, indicate below: Is the property in queslion:
❑ Reai Properly ❑ Mobile Hmie (IC 61.1
�me of mortgagee or conlract seller
Address of mortgagee or contrad selier (number and street, city, state, ZIP
Name o( assignee or other owner or holder of mortgage
Address of assignee (numberand st2ef, city, state, ZIP code)
Does applicant own property in any other If yes, what county? I What Taxing Distrid?
county in Indiana?
Deduction approved in lhe amount of:
20
Signature
�
COUNTY AUDITOR
20 �._ 20 20 _
1 �
County Auditor
Has this deduction been requested on
properly for wrrent year?� Yes� No
20
Date
20
We certify under the pena(ty of perjury lhat the above and foregoing infortnation is true and correct and that the applicants was / were
esident of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Atlomey
or by IC 6-1.1-12-.07
Address of authorized person
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