HomeMy WebLinkAboutMortgage_Rudolph���' � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS �
i� FOR DEDUCTION FROM ASSESSED VALUATION T ip Year
� ! State Fwm 43709 (R6l 5-06)
Presaibed by Oeperiment of Local Govemment Finance ^ n
r� r
INSTRUCTIONS: ��_ _Fi�
To be filed in person or by mail with the County Auditor of the county whe�e the propeAy is located. ��'
Frling Dates: 1) Real Properfy: Du�ng the 12 months befo�e ,lune 11 of the year the deduction is fo ��R6i16�1b0UNTY AUDITOR
2J Mob�7e Homes assessed under !C 6-1.1-7: Between January 15 and March 2 0/ the year the deduction is to be eflective.
See reverse side for additional instnictions and qualifications. �
contract buyer - sse
Assessed value oi real property
March 1, current year
no, what is his / her exact
mortgagee or contract
on reve�se
Key ber/legan�description "/nn'
� �/ '�d - ��� - C/UC/ .
oa� -� �
{ Mortgage / Contract indebtedness unpaid as o
March 1, wrrent year
Address of mortgagee or contrac[ seller
Name of assignee or
owneror
and street,
below:
and street, city, state, ZIP code)
appliqnt own properry in any other I If yes, what county?
v in Indiana?
Page number n� �
d
f Is the applicant the sole�legal or
ownef? Q Yes � No
someone other than spouse, indicate with whom.
Is the properly in quesdon:
❑ Real Property 0 MobOe Home QC 6-1.1-7)
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Taxing DisG Q � '\q�/J�pI1'J� _,,/�
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COUNTY AUDITOR
)eduction approved in the amount of:
20 20�� 20�� 20 20
e P P
Signature Counry Auditor
20 I 20
Date
We certify under the penalty of perjury that the above and foregoing infortnation is We and cortect and that the applicants was / were
'esident of Indiana and owner of the aforementioned property on March 1, 20
� i' _ .
�F/ull resident adc
6/�hl. ���.
S!- O�K-/a,.�o( ('•�f� /,v
or by IC 6-1.1-12-.07
Address ofauthorized person