HomeMy WebLinkAboutMortgage_Besing (7)aM��1i��
a�' " A STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�i�`,��4 FOR DEDUCTION FROM ASSESSED VALUATION
� C: _ -r� State fortn 43703 (R6 / 5-06)
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Presaibed by CepaY�rent of Lonl Govemment Firiance
INSTRUCTIONS .
To be filed in pe�son or by mail with lhe County Auditor of (he county where the p�operty is located.
Filing Dates: 1) Rea/ Property: Dunng the 12 monihs 6ePore ,lune f 1 0( the year the deduction is to be e�g�,Ye� 4 200%
2) Mobile Homes assessed unde� 1C 6-1.1-7: Between January 15 and March 2 o(the yea� the deduction is to be elfecfive.
See reverse side lor additional instructions and qualifications. �� �„�_ -^^
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Applicant (owner or confract byy� -
Assessed value ofrealproperry as of
March 1, current year
no, what is his / her exact share of interesi?
If name on record is diHerent than
of moAgagee or contract seiler
Key numtier / legal desaiption // Record number �
/ v
�l0'd�I � c�Da -ODb• number 3 S� �O
MoAgage / ContraG indeble�ess unpaid as of is the applicant the sole legal or equitabl�
March 1, cur�t year Ig' 141 � ownef? ❑ Yes ❑ No
o� DC��
If owned wiih someone other lhan spouse, indicate with whom.
indicate betow:
Address ot moRgagee or conVact seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address oS aesignee (numberand st2et, city, state, ZIP
s the property in question:
� Reai PropeAy ❑ Modle Home QC 6-1.1-�
Dces appiicant 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� No
COUNTY AUDITOR
Deductic� � appro� ed in ,he anou �. c;: S7 U(iK,�l / �} P� � —
7
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Signature
County Auditor
We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were
resident of Indiana and owner of the aforementioned property on MarcFi 1, 20
�nature (owners full name) Person authorized by duly executed Power of Attomey
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u resiaem aaaress oi appucam v IHooress oi autnonzea person
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