HomeMy WebLinkAboutMortgage_Meece�'�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S J State Form a3709 (R4 / 10-07)
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� PrescribeC by Department of Local Govemment Finance
INSTRUCTIONS: � � Fiie M� �
To be Rled in person or by mail with the County Auditor o/ the county whe2 the property is located.
Filing Dates: 1) Real Property: During the 12 months belore May 11 0l the year the deduction is to be ef/ecti JN ��
2J Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 0/ the year th �deduct�7ln ��o��e eHective.
See reverse side for additional inst ctions and qualifrcations. u
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�Applicant (q erorcontraFt �uye� see r�strjefsons on reverse �ir{e� �/)
Taxing Dislrid
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Assessed value of real property as
March 1, curtent year
If no, what is his / her exad share of interest?
If name on record is different than that
of mortgagee or conVad
number / legal description I Rewrd number b 3
M� _ 61/1/� �_� Page number �� 3 7
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Mortgage / Contrad indebtedness unpaid as of Is the applipnt the sole legal or equitable
March 1, currenl ear owneR ❑ Yes ❑ No
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f owned with someone other than spouse, indicate with whom.
Address of mortgagee or contract seller (number
indicate below:
Name of assignee or other owner or holder of mortgage
Address of assignee (number and st2et,
Does applicant own property in any
county in Indiana?
Deduction approved in the amount of:
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Signature
state, ZIP code)
state,
If yes, what county? � What Taxing District?
COUNTY AUDITOR
20 n� 20 O %
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County Auditor
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s t roperty i question:
❑ Real Property O Mobile Home QC Fr1.
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Has this dedudion been requested on
property for wnent yeaR � Yes ❑ No
20 �]_ 20
P
Date
/ We certify under lhe penalty of perjury that the above and foregoing infortnation is true and corred and that the applicants was / were
residenl of Indiana and owner of the aforementioned property on March 1, 20
ure (owners (ull n me Person authorized by duly executed Power of Attomey
J., l/M.�� n r� . �'/ r�,/ ����o . or by IC 6-1.1-12-.07
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person