HomeMy WebLinkAboutMortgage_Tooley.� ^�n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
,._. ,= FOR DEDUCTION FROM ASSESSED VALUATION
Slale Fortn 43709 (R81 2d7)
�° y� r Presmbed by Department of Lacal Govemmmt Finance
INSTRUCTIONS:
To be fiied in person or by mad wrth the CountyAuditor o/ the county where the properfy is located.
Filing Dates: 1 J Real Property: Dunng the 12 months belore June 11 0/ the year the dedutfion is to be eflec6ve.
2J Mobile Homes assessed under IC 6-1.1-7: 8ehveen January 15 and March 2 o/fhe year the deducSwr is tc� �If�ti�.2008
See reverse side la addi6onal instructions and qualificafions.
A�iraqt (ownerormn e/ "jee �esficfions�reve - ) n 6 �,
-r[- rw-vwr�o /-cr
ed value of � papaty as d March 7, anenl year
rhat is his / her exaa share M inlerest?
If name m recortl is diRerenl lhan Ihal
rmrtgagee or conbact
I Contract indeWedness unpaid as of March 1
w mnlrad seller (number arM street, dly, sfafe, and
assigriee a dher owner or hdder of mortgage
Address of assignee (rnim6u aM sUeel. dty. sfate. arM
Daes appicarit own property in arry olhet —I If yas. whal tamt�?
county in Intliaro?
❑Yes ❑No
Deduction approved in lhe amount of:
�
Sgnawre af Counry Auditor
zo
wmaone
��
spouu, indicate with whom.
« eqinlade avrier�
❑Yes ❑ No
Is the property in quesGon:
❑ Real Property ❑ Mobile Hwrie QC 61.1
Whal Ta�dng D'a4iG? Has Uus dedudia� been reqursletl on pfoperly
. - for wrtenl yeafl
❑ Yes ❑ No
Drawer NO• °?��••••""'
Card NO• �03 �•"""' _
� p �`Ki, 4 3`�• �°(o —
zo
oa�e �n,mW. aar. yea�
zo
I/ We ceNfy under the penalty of perjury that Uie above and foregoing infortnation is We and coaed and that Ihe applicants was I were a resident of
Indiana and owner of ihe atoremenaoned property on March 1, 20
!riawre (owners nd�name� _ . oale (mmth, day, yea�
of applicam
arM ZIP code)
ol Allomey w by IC 61.142-.07
Address of aulha¢ed person (number arM sfreet, �y, stafa.
day. Yea�
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