HomeMy WebLinkAboutMortgage_McIntyreeY �
/e< A STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'ia ry' S FOR DEDUCTION FROM,ASSES$ED VALUATION Count Township Year
� ,r�l�.,i4��.- i' �. . ��
. , u. ! Sute Form 43709 (R6 / 5-06) � � -
� Resaibed by Oepartment of Local Gwemment Finance
INSTRUCTIONS: SEP 1 �.��(��
To be filed in person or by mail with the Counfy Audito� ot the county whe�e !he property is located. �-y,,
Filing Dates: 1) Real Property: Dunng the 12 months before ,lune 11 0/ the year the deduction is to be efli�Ctf ��
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of th���e��r�prA��� elfecfive.
See reverse side for additional instrtictions and quali(ications.
Applicant( e�orcontr$ctbuyer
Tauing ' � d
„
Assessed v�l� of real properly as of
March 1, w��nt year
If no, what is his / her exact share of
Key number� al scription � Record number
�?G/ � a,��o'o.� ��� %
� Page number �
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or
March 1, current year ownef? ❑ Yes ❑ No
owned with someone other lhan spouse, indicate wilh whom.
If name on record is difterent than that of applicant, indicate below:
�me of moAgagee or contrad seller (
����o,
Address of mortgagee or contract seller (number and street, city, state, ZIP
Name nf_��e:..--- -- ' �age
��..4....✓•J'� 1
Dra���er N�� ziP �oae�
c
GardN�; •,....`., •'K�`G ���y���y�
n �m��„ (,l`t�.ez l� I ,
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Deduction approved in the amounf of:
20 �_ 20 20
P Q
Signature
s the property in question:
❑ Real Property ❑ Mobile Hane pC Cr1.
a
What Taxing Distrid? Has this deduction been requested on
propeAy for current year? � Yes ❑ No
COUNTY AUDITOR
20
County Auditor .
�
20
20
certify under the penalty of perjury that the above and foregoing infortnation is true and corred and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 7, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
� I rup/resitlent atltlfess of app i�ant Address of authorized person
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