HomeMy WebLinkAboutMortgage_Dyer (2)rt�° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun .�nwnship. Year
` ti «•� � Slate Form 43709 (R4 / 10-07 ) t7{��,� 5
� Prescribetl by DepaNrenl W Local Govemment Finance .tt-�
MAY 0 2 20
INSTRUCTIONS: , F�e M�
To be filed in person or by mail with the County Auditor of the county whe2 the property is loca d. I
Filing Dates: 1) Real PropeRy: Dunng the 12 months belore May 11 0/ the year fhe deducBon i �o tZe eH�id,e.)
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and Ma�ch 31,of the-year,tle�deduction is fo be effective.
See reverse side /or additlonal inshuctions and quafificaGons.
Ap icant o erorcontract buyer- e rest o on reverse side) . ..
�'
axing istrict Key num r/ legal description Record number
O—� / — Page number
Assessed value of real properiy as of Mortgage / Contrad indebtedness unpaid as of Is the applicant th sole legal or equitable
March 1, curtent year March 1, currenl year owne(? �Yes ❑ No
Ii no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
-�,.0-0 - � - . I -0O
If name on record is different ihan that of applicant, indicate below: Is the property in question:
LKReaI Roperty ❑ Mobile Home (IC 61.1-n
�me of mortgagee or contrad seller � •
Address of mortgagee or conVact seller (number and st2et, city, state, ZIP
Name of assignee or other awner or holder of mortgage
Address of assignee (number and sGeet, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has this deduction been requested on
county in Indiana? property for curtent yeaR � Yes 0 No
COUNTY AUDITOR
Deductio pproved in the mount of:
20 20 0 20 20 20 �� 20 �� 20 �_
o � � � P P
ignature County Auditor Date
/ We certiy under the penalty of perjury lhal lhe above and foregoing informalion is true and corred and that the applicants was / were
, residenl of Indiana and owner of the aforementioned property on March 1, 20
i nature (owners full name Person authorized by duly executed Power oi Attomey
or by IC 6-1.1-12-.07
Full si addre f applipnt Address of authorized person