HomeMy WebLinkAboutMortgage_Schmitt (2)�'��A� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION
� J State Fortn 43709 (R6 / 5-0G)
Presai6ed by Depanment of Loml Govemmenl Finance
INSTRUCTIONS:
Coun Township Year
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To 6e tiled in person or by mail with the County Auditor of the county where the property is located.
Filing Dates: 1) Real Property: During the 12 months before June Il o( the year the deduction is to be Uve.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the ye r t ��is to be eflective.
See reverse side for additional instructions and quali(ications. ��BSON COUNTY qUDITOR
Applicant(ownerorcon fbuyer-see�tri 'o mreverse de)
Taxing Distrid Key number / legal description Record number
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Assessed value of real property as of MoAgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curtent year March t, current year owneR ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mohile Hane (IC Cr1.1-�
�Name of mortgag e o conVact selier
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Address of moRgagee or conVad seller (number and stieet, city, tat , ZIP
Name of assignee or other owner or halder of mortgage
Address of assignee (number and st2et, city, state, ZIP code)
Does applicant own property in any other If yes, what counry? What Taxing Distrid? Has this deduction been requesled on
county in Indiana? property for current yeaR� Yes❑ No
COUNTY AUDITOR
Dedudion approved in the amounl oP �
20 20 �� 0 O 20 20 20 20
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Signature County Auditor Date
�I/ We certify under the penalty of perjury lhat the above and foregoing information is true and corred and that the applicants was / were
a resident of Indiana and owner of the aforementioned property on March 1, 20
Signature (owners full name) Person authorized by duly executed Power of Attomey
4
� � or by IC 6-1.1-12-.07
F II esident address of applipnt Address of authorized person
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