HomeMy WebLinkAboutMortgage_HelsleyR,,,.
STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Year
S / Sfate Form 43709 (RS / 4O3)
�«
Presai0e0 Oy Departmem ot Local Govemment Finance
INSTRUCTIONS: � � F�a�, Y 6
To be filed in person or by mail with the County Auditor of the county where the property is located. � ��L� �L!
Filing Dates: 1) Real Property: During the 12 months before May 11 0/ the year the deduction is to 6e eRectiv�, „ t �� ,�nn�
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o/the year the d�eCtw i-to� ecfive.
See reverse side Ior additional instructions and qualifications. � ,%/ „ n
Applicant (owner o�
Taxing District
l�
Assessed value of real property as of
March 1, current year
no, what is his / her exact share of interest?
reverse
number / legal
Record number
Page number
�C� — OD��l �- 00 la c,
MoAgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, currenl year owner? es ❑ No
If name on record is difterent than that of applicant, indicate below:
of mortgagee or contract seller
�s of mortg�e or contracl seller (num
�
of assignee or other owner or hold re of
��
ss of assignee (number and street, ciry,
street, city,
code)
�
If owned wilh someone other than spouse, indicate with whom.
� - _ /Oo - GI�X�. 4 %� - G�
Is lhe property in question:
p,F}eal Property ❑ Mobile Home (IC E1.1-7)
- I �-I �-I
-�q5a,
Does applicant own property in any other If yes, what county? Whal Taxing District? � aµ, �'--"-'°^��asted on
wunty in Indiana?
er 0..(,�PJ.:.�, � .� � '� No
�ard NO: � —
COUNTYAUDITOR ��� ���""""••
�. , —
Deduc6on approved in the amount of:
z� �6 A I zo
r�
20 r} � 20 �� 20 � 20 � 20
P �°
County Auditor Date
We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were
esident of Indiana and owner of the aforementioned property on March t, 20
ry�fnr� (owners fu/l narqe) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person
l�-�Ynnr,