HomeMy WebLinkAboutMortgage_Oneal (4)•�•TM STATEMENT OF MORTGAGE OR CONTRACT
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a' =_ ` INDEBTEDNESS FOR DEDUCTION FROM _ASSESSED
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�`- ' VALUATION State Form 43709 (1-90) Prescribed by the
�� � State Board of Tax Commissioners
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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 11 of the year the deduction
is to be effective. See reverse for additional instructions and qualifications.
or con�act
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Taxing District
see r�strictions on reverse)
Key Number/Legal Description
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Filin fee $1.00
County Township Year
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�f w^�.�'"'. r.l!DITOR
Record No.
No. (� �a
Assessed value of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March t, current year as of M�rh 1, current year. . equitable owner? O yes rJ no
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If no, what is his/her exact share or interest? If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:�� _�D -O�-oZU/- U00•
��e of mortgagee or contract seller (
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Address of mortgagee or contract seller
Name of Assignee or
Address of Assignee
owner or holder of Mortgage.
Does applicant own !eal property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
• year? O yes O no
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Deduction appr ved
19� 19�
Signature
COUNTY BOARD OF REVIEW ACTION
in the amount of:
0
19�„fj�/ 19a_�' ��'�i�b�,%i
,��-D1 _ ., o
Secretary of Board of Revy?�
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Date s2$. 0'
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I/We certify under penalty ot perjury that the above and foregoing infqrfnation is true and correct and that the appli-
s was/were a resident of Indiana and owner of the aforementioFfed property on March t, 19
S�gnatur (owners full name) Person authorized by duly executed Power of Attorney or
h �/j ,. .-���. � by IC 6-1.1-12-.07).
Address
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Address of Authorized Person