HomeMy WebLinkAboutMortgage_Johnson (2)`�E SUIFO
�'.
.
,,��r
� �816
STATEMENT OF MORTGAGE OR CONTRACT
INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
VALUATION State Form 43709 (1-90) Prescribed by the
State Board of Tax Commissioners
T
��
ear
Instructions for filing: �
To be filed in person or by mail with the County Auditor•of the county where the ,J qi� 1$ 2QQQ
property is located during the 12 months before May 11 of the year the deduction ;, �
is to be effective. See reverse for additionai instructions and qualifications. r/ ` r` •�_�� /]�
. ,'t'L, e�,_,_�- :; �.. ,�_ -t7
, QG � � • 2 ! J ����. _ �".;`; Y AUDI70Ft .
../
Applicant ner or cont„raFt r- ee str n r verse)
�1L
Taxi District ey Number/ ega escription Record No.
(�i�ie:�J(�/r1L/�-�%�_ ���—�(�J 7 S—�� Page No. 7`
Assessed value of real property as Mortga e/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as of�ch 1, current Year. equitable owner? O yes � no
�V
If no, what is his/her exact share or interest? If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of appiicant, indicate below:
Name of mortgagee or contract seller
Address of mortgagee o� contract seller �
Name of Assignee or other owner or holder of Mortgage. � '
Address of Assignee ' '
Does applicant own real property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
year? O yes J no
COUNTY BOARD OF REVIEW ACTION �
Deduction approved in the amount of: �
i9 i9�bD2 ��� y9 dioa3 i9�+ �'�.r ��
,� - �ol . 6.ro Pr �' �
Signature _ Secretary of Board of Review Date
y,4vh 0� 0
Q P
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
�nts was/were a resident of Indiana and owner of the aforementioned property on March 1, 19
ature owners fu�name) < Person authorized by duly executed Power of Attorney or
a,`Q� ��`- by IC 6-1.1-12-.07).
Fult Resident Address of plicant Address of Authorized Person
(�IP � l30 8� D