HomeMy WebLinkAboutMortgage_Edwards,.�""' STATEMENT OF MORTGAGE OR CONTRACT
:�� INDEBTEDNESS FOR DEDUCTION FROM ASSESSED Filin fee $1.00
,� � County Township Year
VALUATION State Form 43709 (1-90) Prescribed by the
�' d State Board of Tax Commissioners
a ' File M
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. �._. ,' L�O� .
or
ng District
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�see re�1strictions on rev�e)
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Key Num er/Legal Description
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Record No. �
No. �
Assessed value of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as of March 1, current year. equitable owner? �7 yes O 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:
me of mortgagee or contr sell r
�
�ress of mortqaqee or contract sell
Name of Assignee or other owner or holder
Address of Assignee
rtgage.
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Does applicant own real 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 ❑ no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
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Secretary oi Board of Review � Date
1
certify under penalty of perjury that the above and foregoing,information is true and correct and that the appli-
was/were a resident of Indiana and owner of the aforementioned property on March 1, 19
itur owners tul� e� „ �'' ' f'erson authorized by duly executed Power of Attorney or
�� by IC 6-1.1-12-.07).
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Resident fiddress of Aplicant _ _ � Address of Authorized Person