HomeMy WebLinkAboutMortgage_Boyd/i' "��°� STATEMENT OF MORTGAGE OR CONTRACT INU�BTEDNESS
'i: �; FOR DEDUCTION FROM ASSESSED VALUATION
�-«. ✓ SlateFOrtn43709 (R6/5-06) . . . � .
Presaibed by Depanment M Local Govemment Finance
INSTRUCTIONS:
qt a� - T h' Year
��QN 2 [008
File Mark
To be liled in pe�son or by mail with the County Auditor of the county where the propeRy is localed. �a-� �,�!_
Filing Dates: 1) Real Property: Dunng the 12 months 6efore �une it of the year the deduction is to b eflecfive. (/ ���
2) Mobile Homes assessed unde� IC 6-7. 7-7: Between January 15 and �March 2 of the }���r�ft'i� 6�UE�bYi Attplllplgflective.
See reverse side for additional instructions and qualifications.
Ap 'cant (ow, ._n�e'rorcont�buyer- ee restridions o verse side)
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Tauing istrid Key numb / legal d cription Record numbero �
a �, -,� - aG -� ao -��i �a PagePumber � 1 3 !
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Assessed value of real properiy as of Mortgage / Contrect indebtedness unpaid as of Is the applipnt the sole legal or equitable
March 1, curtent year March 1, current year owner? � � Yes Q No "
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
. �❑ Real Property ❑ Mobile Horne pC Fr1.1-�
�e of mortgagee or contrad seller
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Addrese of mortgagee or contr G seller (number and stieet, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and street, city, state, ZIP code)
�oes applipnt own property in any other If yes, what county? What Taxing Distrid? Has this deduction been requested on
counly in Indiana? property for current yeaR � Yes � No
COUNTY AUDITOR
Deduction approved in the amount of:
20 � 20 �� 20 20 20 20 20
P
Signature County Auditor Date
.We ceAify under the penalty of perjury lhat the above and foregoing information is true and corred and ihat the applicants was / were
esident of Indiana and owner of the aforemenlioned property on March 1, 20
Si nature,(�_owners full n�) Person authorized by duly exewted Power of Attomey
U�,fti�a rij� o�byics-i.i-iz-.a�
Full reside�i addr s of applipnl a(0 7� . S �, e c�. Address of aulhorized person
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