HomeMy WebLinkAboutMortgage_Cavett�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
� FOR DEDUCTION FROM ASSESSED VALUATION
µ• f State Fofm 43709 (R4 / t Q-07 )
� Prescribe0 by Department of Local Govemment Finante
INSTRUCTIONS:
Coun Township Year
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N O V O File,M�rk
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To be filed in person or by mail with the County Auditor o/ the county where the property is located. R
Filing Dates: 1) Real Propedy: During !he 12 montbs befo2 May 11 oJ the year the deduction is to be eNective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 0l (%e year•the dedu� to be eHective.
See reverse side Ioradditional instruc6ons and qualificaGons. � GIS��; Y::UDITOR
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Applicant o e or conhacf buy r- see res ns on �eve e ide)
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T�g Dislrid Key number / legal description _ Record number
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Assessed value of real property as of MoAgage / Contred indebtedness unpaid as of Is the applipni the sole legal or equitable
March 1, wrrent year March 1, curtent year owneR ❑ Yes ❑ 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:
❑ Reai PropeAy ❑ Mobile Home (IC 61.1-n
�me of mortgagee or conVad seller
Address of mortgagee or contract seller (number and street aty, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and stieet, city, state, ZIP code)
Dces appliqnt own property in any other If yes, what county? What Taxing District? Has this dedudion been requesled on
county in Indiana? property for anent yeaR � Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
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Signature County Auddor Date
�We certify under the penally of perjury that the above and foregoing infortnation is true and correct and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
nature (owners (ull name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
ulI resident address of applipnt Address of authorized person
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