HomeMy WebLinkAboutMortgage_Trader� rt�' , STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�-- _: FOR DEDUCTION FROM ASSESSED VALUATION
•p �+ State Fwm 43709 (R / 72-99)
�� Pre5cri0ed by State Board ot Tax Commissioners
InsVuctions for filing:
To be filed in person or by mail with the County Auditor of the county where the property is
located during the 12 months before May 11 of the year the deduction is to be effedive. See
reverse side for additional instrudions and qualifications.
or cont2ct
AssessedNalue ofreal
March 1, current year
on
number / tegal
FORM 5
Filing fee 51.00
Coun Township Year
� �
File Mark
MAY 1 1 2001
GIB/�iTY A.IJDITOR
Record number /� /
(
O /�_OvOS � � , Page number
� � / G
as of Mortgage / Contract indebtedness unpaid as of Is lhe applicant the sole legal or
March 1 c rrent year ownef? ❑ Yes ❑ No
��/ '1/�.r�-r� I
If no, what is his / her exact share of interest?
If owned with someone other than spouse, indicale with whom.
-do-1�4--Ib3-
If name on record is different than lhat of applicant, indicate below:
'ame of mortgagee or contrad seller / n /lr7
�� --� �v l,
Address of moRgagee or wntract seller (number and st e, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and street, city, state, ZIP code)
Does applicant own real property in any If yes, what county? What Taxing Disirict? Has this deduction been requested on
other county in Indiana? property for current year? ❑ Yes� No
PROPERTY TAX ASSESSMENT BOARD OF APPEALS
Deduction approved in the amount of:
20 � �e" /b � 20
!We
s
r�.l�
. .L��
Secretary of PTABOA
20
20
Date
a��f�
I�I I � I
nder the penalty of perjury that the above and foregoing information is true and correct and lhat lhe applicants was / were
of diana and own r of the aforementioned property on March 1, 20
ne I m� / Person authorized by duly executed Power of Attomey
„ ,� pt or by IC 6-1.1-12-.07
person