HomeMy WebLinkAboutMortgage_Meriwether�"„F STATEMENT OF MORTGAGE OR CONTRACT
i 4 INDEBTEDNESS FOR DEDUCTION ,FROM ASSESSED
� VALUATION State Form 43709 (1-90) Prescribed by the
�-� ` f' -�'' State Board of Tax Commissioners
fee $1.00
Instructions for filing: i?'� 1� �i�e�la�c�;
To be filed in person o� by maii with the County Auditor of the county where the � � � Z��Q �
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. `� /i � O
/j ,�R��ii�-=n -:�- 1
Appiicant (Owner or co ract buyer - see �estrictions on eve �
T�cing District Key Number/Legal Description Record No. �
/ R, i .. �
, U Page No. �5
Assessed va of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as March 1, current year. equitable owner? O yes � no
� — Os b- �
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:
of mortgagee or contract seller
Address of mortgagee or contract
Name of Assignee or other owner or
Address of
�
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p o- 6y �l
po- 6g1
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? ❑ yes �J no
- COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
3!�1 19 60`�,
p � �. . v)
gnature
a d 07 � g �
�_ •��� I I�'lo FT,i-6d►tf- �1��� I�O�' I��
Secretary of Board of Review � Date
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
�nts was/were a resident of Indiana and owner of the aforementioned property on March 1, 19
��g t (owners full name) Person authorized by duly executed Power of Attorney or
_-�.. ..� _ ��.. __ � �. . � , by IC 6-1.1-12-.07).
Resident Address of Aplicant � Address of Authorized Person