HomeMy WebLinkAboutMortgage_Krieg (6)/�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
t,
FOR DEDUCTION FROM ASSESSED VALUATION
�J• Slate Form 43709 (R6/ S-06)
�M• Presaibed by Department of Loml Gwemment Finance
INSTRUCTIONS:
To be filed in person o� by mail with fhe County Audito� ol the county where the property is located.
Filing Dates: 1J Real Property: Dunng the 12 months before June Il of the year the deduction is to be ef/ective. C� 1 q� O$
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o(the year the deauc on �s% etrective.
See reverse side for additional instrucG'ons and qualfica6ons. `�-jj�, �,�,
(owner or
see restrictlons on v rse side�
Key num er / legal cjE
' - V -U ' • 6E�D'
Assessed lu of real property as of Mortgage / Contrad indebtedness
March t, curcent year March 1, curtent year
�
as of I Is the applicant the sole legal or
owneR ❑ Yes ❑ No
If no, what is his / her exad share of interest? If owned with someone other lhan spouse, indicate with whom.
If name on record is difterent than ihat of applicant, indicate below: Is the property in question:
❑ Real Properiy ❑ Mobile Home QC 61
�e of mortgagee or contract seller �
O 1�Yi�Ci�Y�--`�C�KL�[s�-Q�J'�
Address of mortgagee or contrad seller (number an�reet, city, state, ZIP
Name of assignee or other owner or holder ^' �^^^^°^°
Address of assignee (number and street, c n I":l �1' C[' t' �.�1 �L1.`: ... ..
Dces applicant own property in any other I � .Q ���
, Vg•�
county in Indiana? C� C� � � . .....................
-�35,a�
�ximr� �,a, B�'�S
Vuun � r Auu� I UFL
Deduction approved in the amount of:
20 Q� 20 �_ 20
1" P
Signature
Full
�
County Auditor
20
�
u
Has this deduction been requested on
property for curtent yeai? � Yes ❑ No
�
Date
20
certify under the penalty of perjury that the above and foregoing information is true and correct and that ihe applicanls was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
0
Person authorized by duly exewted
or by IC 6-1.1-12-.07
person