HomeMy WebLinkAboutMortgage_Whitman,��'"'E STATEMENT OF MORTGAGE OR CONTRACT
��INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
VALUATION State Form 43709 (1-90) Prescribed by the
��' :�` State Board of Tax Commissioners
Instructions for filing:
To be filed in person or by mail with ihe County Auditor of the county where the
property is located during the 12 months before May 11 oi the year the deduction
is to be effective. See reverse for additional insiructions and qualifications.
MAY 0 5 1999
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Applicant (Owner c ct bu er -,�e� re tions on revers
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Ta � g District Key Nu er/L gal Description Record No.
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Page No.
Assessed value of r property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current e r as of Mar rre�nt yearO equitable owner? O yes �7 no
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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:
Name of mortgagee or contract seller _ •
Address of mortgagee or contract seller
Name of Assignee or other owner or holder of Mortgage.
Address of Assignee
Does appiicant own !eal 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 O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19_��-_OV 19. 1��;1_ `Q 1� d d3 19 � 19 tJ
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Signature _ Secretary�f Board of Review Date
��o� ao�r—� o P � �O17�99
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
��nts waslwere a resident of Indiana and owner of the aforementioned property on March 1, 19
gnature (owners full ar�e) Person authorized by duly executed Power of Attorney or
by IC 6-1.1-12-.07).
Full Resident Address of Aplicant � Address of Authorized Person
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