HomeMy WebLinkAboutMortgage_Skelton� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
` FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�. J State Fwm 43709 (RS I 4-03)
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PresaiEetl Dy Department of Local Govemment Finance
I�NSTRUCTIONS: File Maric �
To be filed 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 May 11 0l the year the deduction is to 6e effective. ��
2) Mobile Homes assessed under IC 6-1.1-7: 8etween January 15 and March 2 0/ the year fhe deduction is to 6e ef/ective.
See reverse side !or additional instructions and qualifications.
(owner or
Taxing Distrid
buyer- see restrictions on
Key number / legal description
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/- a� ,998. - � Page number
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applipnt the sole legal or equitable
March 1, curtent year March 1, current year ownef? ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned with someone olher than spouse, indicate with whom.
dG-a�- � �oa-vvo. -oo
If name on record is different than that of applicant, indicate below: Is the property in question:
mortgagee or contrad seller
Address of mortgagee or contrad selier (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, ciry, state, ZIP code)
Does applicant own property in any other If yes, what county? I4
county in Indiana?
Dedudion approved in the amount
20 f2� I 20
couNrr aui
20 � 20 Q�
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County Auditor
❑ Real Property ❑ Mobile Home pC G1.1-�
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Dra��� 03 .. . . �OIS�DDO ' equested on
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20
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20
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20
I/ We certify under the penalty of perjury that the above and foregoing information is Irue and corred and that ihe applicants was / were
`resident of Indiana and owner of the aforementioned property on March 1, 20
name)
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applicant
Person authorized by duly exewted Power of Attomey
or by IC 6-1.1-12-.07
person