HomeMy WebLinkAboutMortgage_Johnsr�n � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
`i�-� FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
\s w� ! State Form 43709 (R6/ SW)
�j Presaibed by Department of Local Gwemment Finance �
INSTRUCTIONS: � � ��
To be filed in person or by mail wrth the County Auditor o/ the county where the p�operty is locaf
Filing Dates: 1) Real Property: Dunng the 12 months before June 11 of the year the deduction i be-eff
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the yea� the d ducGon is to be effective.
See reverse srde foradditional instnicUons and qual�cations. �AN � b 2���
�ct b��yer
� U �
T
Assessed value of real properiy as of
March 1, curtent year
16no, what is his / her exad share of
on
Key number / legal description
�o -/`�-a %-iUo -ovd. 3.
D�3- D� 35�I��
MoRgage / Contrad indebtedness
March 1, current year
If name on record is different ihan fhat of applicanl, indicate below:
mortgagee or contrad seller
Address of mortgagee or conVact seller (number and
Name of assignee or other owner or halder of mortgage
Address of assignee (number and st2et, city, state, ZIP code)
Does applicant own property in any olher I If yes, what county?
county in Indiana?
Deduction approved in lhe amount of:
20 �
\
Signature
20
1�
�bs°
i
ed with sc
as
�SON COUNTY AI
Record number
��_
Page number '
Is the applicant the sole legal or equitable
owne(? ❑ Yes ❑ No
otherthan spouse,indicate with whom.
� �e /}-.��
� `�''�
'���DOI�
What Taxing Distrid?
COUNTY AUDITOR
20 20 20
County Auditor
O Mable Hmie (IC 61.1-�
Has this deduction
property for current
20
20
iesietl on
Yes � No
We certify under the penalty of perjury thal the above and foregoing informalion is true and correct and that the applicants was / were
resideni of Indiana and owner of the aforementioned property on March 1, 20
�nat (owners full narp� _`_ � Person authorized by duty executed Power of Attomey
\ .. __. !-�f\ I 1 � . or by IC 6-1.1-12-.07
pereon