HomeMy WebLinkAboutMortgage_Tyring.��•^a STATEMENT OF MORTGAGE OR CONTRACT
�a��P� ` INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
`- `a'" e VALUATION State Form 43709 (1-90) Prescribed by the
� State Board of Tax Commissioners
�
Instructions 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 i 1 of ihe year the deduction
is to be effective. See reverse for additional instructions and qualifications.
or contract
Taxing
see
Key
on reverse) .
egal Description
_ l�"Yi��s
Filin fee $1.00
County Township Year
.
File Mark
OCT 2 4 ;;,���
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Record No.
No.
Asse�sed value of al property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, curre year as of March 1, current year. equitable owner? O yes O no
If no, what is his/her exact share or interest? If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate
e of mortgagee or contract seller
Address of mortgagee or contract seller
Name of Assignee or
of Assignee
owner or holder of Mortgage.
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Does applicant own !eal property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
year? O yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19
Signature
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of
Date
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I/We certify under penalty of perjury that the above and foFegoing information is true and correct and that the appli-
's was/were a resident of Indiana and owner of the aforementioned property on March 1, 19
�ynature (owners full name) Person authorized by duly executed Power of Attorney or
, ll,�i__ .0��. 2_ �, by IC 6-1.1-12-.07).
Full Resident Addr�ss of�Aplicant � Address of Authorized Person