HomeMy WebLinkAboutMortgage_Akers (2)STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
' ' FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Year
µ� f Slate FOfm 43709 (R4 / 10-01)
Prescribed by DepaMient of iocai Govemmeni Finance -C�
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INSTRUCTIONS: Fil
To be filed in person or by mail with the County Audilor o/ the county where the property is located. J N IV 1��3
Filing Dates: 1) Real Property: During (he 12 months belore May 11 of the year the deduction is to 6e e(/ective. �
2) Mobife Homes assessed under IC 61.1-7: Belween January 15 and March 31 0l the �ear the ded cti�o/���is to 6e eH ive.
See reverse side (or additional instruc6ons and qualifications. ��"`'�"v! �y�'�
GBSON �!�N1F .SUQITOR
or contract
Tauing Distrid
Assessed value of real
March 1, current year
as of
If no, what is his / her exact share of interest?
on reverse side)
Key number / legal description
�oa-p3� aa --a�
March 1, cqur{rent year
v .-� r., _
name on record is different than that of applicant, indicate below:
mortgagee or contract seller �
,
of moRgagee or contract seller (number and str�
Name of assignee or other owner or holder of mortgage
Address
street,
Dces applicant own property in any other If yes, what
county in Indiana?
Deduction approved in the amount of:
� � /� , �
Signature _
� �u� IOaO
Rewrd number
Page number
is me appncanr me soie iegai or
ownef? ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
❑ Real Property ❑ Mobile Home (IC G1.
.3 .� � , � �� ��`i �
ciry, state, ZIP �� ��
/ � �. � 1
3) ��a�yeY�O••,
Ca<a�p.
COUNTY A� . �R
20 20 20
CouMy Auditor
:�uction been requested on
,,,erty for wrrent yeaR � Yes � No
20
�
20
-��' We certify under the penalty of perjury that the above and foregoing information is true and corred and ihat the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
�nt aGtlreBS of appllcaN Address of authonzed person
/
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