HomeMy WebLinkAboutMortgage_Beck"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
FOR DEDUCTION FROM ASSESSED VALUATION
• S1ate Form 43709 (R71 / 609)
�' � Presaibed ?/ OepartmeM af Locel Govemment Franca
File a
INSTRUCTIONS: v�h
To be filed in person w by mail with the CounryAuditor o� Counry Recorder o7 Ne county where the property is located. V 20 jU
Fil'ng Dates: 7) Real Property Must file durirg the yearlor which the deduclion is wught � Counry Auditor
2J Mo6ile / ManufaUUred Homes rrot assessed as Real Property.� Must fiie during the nveHe (12) monfhs I''I
before March 31 of each year the deduction is sought e.lJ��,�' R��
See reverse sida7oradUitional instructbns anequalifications. C'�BSON COUN)y �F
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As�sed rdue of rral paper,y a d hb�age / Conbart iMehteE�s unpxitl as W Morigage I ConYact'vx
Mertl� 1. qrtsit year Mardi 1, artent year Eate a( apPfimtion �
u narne m �ecw0 9 antereni than Inat ot app�Cant,
Name N mrtgagee or contract seller �
/
AddRSS W rtnrtga9ce u contraU se0er (numbrJ ar
Name of assignee w oMer owner w M�qr qf morrc
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AdEress of a.signee (nurtrber antl atree4 �}: slate,
Dces applitaM vxn properry in any oNer
�„� �, ���� ❑ Y�
❑ No
DeducGOn approved in Ne amount of.
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$ig(aLne d Camly Auditnr
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Yes, what munfyt What Ta�drg ois
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ss imG� es d b the ePP��t the sde
legal d eQUilahle oarmll
� ❑ Yes ❑ No
�. Indicate ritt� wMrn
P�DenY in 7uesGm: MmiaM Assessetl
a� RoaeAr ❑ Annualh Asessed
Mobile Fiat�e pC 61.1-:
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. i/ We certify uMer Ihe penatty of peryury that the above and foregoing information is We aM cortect arM Nat Me applimnt is a resident of IMiana arM
owner ! contrad buyer of Ne a(oremerrtioned property on date applicalion is filed.
SI (o�meh hdl rertre) Date (month. daY. Yge�
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�Fu0 'dent U appfrani (numGer antl sLeef, tiry, state, antl ZIP ),
/U6°j 5 l015� � �i✓. 7
Pcson autlw�¢etl by Ouy exeaited Pw�er o(AUCmey w by IC 67. -t2-0.7 Date (month. daY. Yea�
(numbereM sneet my. sbte, an0 ZIP wde) .
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