HomeMy WebLinkAboutMortgage_CreedonSTATEMENT OF MORTGAGE OR CONTRACT INDI
- ° FOR DEDUCTION FROM ASSESSED VALUATION
S � State Porm 43709 (R4 / 70-07)
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� PrescribeU Dy Department of L�! Govemmeni Finante
INSTRUCTIONS:
To be filed in person or by mail with the County Audifor of the county whe2 the propeAy is
Filing Dates: 1) Real PropeRy: During fhe 12 months before May 11 of the year the deduction is to be e1SQ��e. ry 2003
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 oI the year�fhe deduc6on �s to be eflective.
See reverse side (or additional instructions and qualifications.
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Ap�' nt (owneror,�n6ac4buVer�eee restnctions on rev2c
Distrid
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Key number / legal desuiplion � Record number
Page number
Assessed value of real properry as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or c
March 1, wrrent year March 1, nt 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 betow: Is the property in queslion:
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of mortgagee or conVad seller
Address o( mortgagee or contrad seller (number and street, city, stafe, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and sUeet, city, state, ZIP code)
Does applipnt own property in any other If yes, what county? VJhat Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for wrrent yea(?� YesO No
Deduc6on approved in the amount of:
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Signature
COUNTY AUDITOR
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County Auditor
20 � I 20 �g 20
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We ceAify under the penalty of perjury that the above and foregoing information is true and corred and that the applicanls was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
address of
Person aulhorized by duly executed Power
or by IC 6-1.1-12-.07
�// /�/ Address ofauthorized person
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