HomeMy WebLinkAboutMortgage_Mowery�"° R"'° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
f Count Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
., •• J S�ate Fotm 43709 (Ra I 10-07) , �{ � �i
� PrescriDeG by DeDaNnenl of Local Govemment Finance ��� a �� `�
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INSTRUCTIONS: f1 tE� e Mark
To 6e filed in person or by mail with the County Auditor of the county where the property is located! E C 1 Q��"�
Filing Dates: 1) Real Property: Dunng Ibe 12 months before May 77 o/the year the deduction.rs to be ef/ectivey �
2) Mobile Homes assessed under IC 6-1.1J: Behveen January 15 and March 31 of the year the.deduction is to be eHective.
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See 2verse side for additional insWCtions and qualifications. ' GI9SC��1 CGUTr7'i ,�UDIT09�
Applicant (owner or
a� _ .� _
Taxing Distrid
buyer - see restrictions on reverse side)
� �ru�� IS�o
Assessed value of real property as of
March 1, currenl year
16 no, what is his / her exact
name on record is different than
number / legal
L
Rewrd number
�o3-�y0
o �2-oDZ9y- � � �`
Mortgage / Contrect indebtedness unpaid as of
March 1, current year
' �
ofinterest?
that of applicant, indicate below:
number
Is lhe applicant the s e legal or equitab
owneR es ❑ No
�, D U I
If owned with someone other than spouse, indicate with whom.
v��i�
�me oi mortgagee or contraG seller
�rifi��t rc� 13a h k N� A,
Address o( m��gee or ntrad seiler (number and street, city, state, ZIP
Z� s.�,3� s�, , �.� .g�� llE
Name of assignee or other owner or hold of mortgage
Address of
and sfreet, city, state, ZIP cotle)
, � L,� .v • �/� r � vv o
s the property in question:
❑ Real Property ❑ Mobile Home QC G1.1-
S
-36i\
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Does applicant own property in any other If yes, what county? What Taxing Distri . Ha this dedudion been requested on
county in Indiana? propeAy for current yeaf? 0 Yes❑ Nc
Deduction approved
20
COUNTY AUDITOR
amount of:
r � / '�/L(��'
County Auditor
20 ��
P
20 09
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I/ We certify under the penalty of perjury that the above and foregoing information is true and correct and thal lhe appliwnts was / were
� a resident of Indiana and owner of the aforementioned property on March 1, 20 .
Signatwe (owner' full name) � Person authorized by duly executed Power of Attorney
� �!__ ° � /j % _ l o� bY ic s-�.�-iz-.o� •
Fu I resident address of appli Address of authorized person
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