HomeMy WebLinkAboutMortgage_JohnsonSTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
' � FOR DEDUCTION FROM ASSESSED VALUATION
� State Fortn 43709 (Ra / 10-07)
PrescnbeE by Department W Local Govemment Finance
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INSTRUCTIONS:
To be filed in person or tiy mail with the County Auditor ol the county where the property is loca
Filing Dates: 1) Real PropeRy: During the 12 months belore May 11 of the year the deduction is to be
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and Maich 31 0/ the y
See reverse side for additional instructions and qualifications. �
Applicant (owneror ntract buyer- see restricfions on reverse side)
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Tauing Distrid y number / legal description
l ' LJI�� �[ ( '
Assessed value of real properry as of MoAgage / Contrad indebtedne:
March 1, current year March 1, cunent year
no, what is his / her exad share of interest?
If name on record is different Ihan that of
mortgagee or contrad
below:
Record
Page number
as of Is the applipnt,/t-,h�e"sole legal or equitable
owneR �/es ❑ No
1
owned with someone other than spouse, indicate with whom.
of mortgagee or conVact seller (number and st2et, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and sheet, city, s[ate, ZIP code)
Does appliqnt own propeRy in any other If yes, what county?
munty in Indiana?
Dedudion approved in the amount of:
Ti7
Signature
r � • i�
;-, . � . •
County
property
❑ Mob7e Harne QC 6�1.
What Taxing Distrid? Has lhis dedudion been requested on
property for current yeaf? � Yes ❑ No
COUNTY AUDITOR
20 � I 20 Q�
20 �_
�
Date
20
r
We certify under lhe penalty of perjury that the above and foregoing infortnation is true and corted and that the applicants was ! were
2sident of Indiana and owner of the aforementioned property on March 1, 20
naturg�(owners /ull�n_alm � Person authorized by duly exewted Power of Attomey
> �� n, . .•.. n _ . � ) � or by IC 6-1.1-12-.07
resident address o�pplicant Address of aulhorized person
at 9 �: �� .�`. oc� � z�