HomeMy WebLinkAboutMortgage_Hynemand rt�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
° = FOR DEDUCTION FROM ASSESSED VALUATION
S J Stale Form 43709 (R4 / 10.07 )
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� PrescribeA by Department ot Local Govemmem Fnance
INSTRUCTIONS:
Coun Township Year
File Mark
To be �led in person or by mail with the County Auditor o( the county whe2 the property is located.
Filing Dates: 1) Real P�operty: Dunng the 12 months 6etore May 11 of the year the deduction o be Nective.� ��.
2) Mobife Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 af t�e �a� the deiluction is to be ef/ective.
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See reverse side (oradditional instructions and quali�cafions.
JNN 2 8 2002
Applican o nerorcontra yer s e restrictions on reverse side) • /I/, /� `��/
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Ta�cin istrid Key number / legal description Record number �/
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Assessed value of real property as of Mortgage / Contract indebfedness unpaid as of Is lhe applicant the sole legal or equilable
March 1, current year March 1, currenl year owneR ❑ Yes ❑ No
3000 C�
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 Ihat of applicant, indicate below: Is the property in question:
❑ Real PropeAy ❑ Mobile Hane (IC 61.1-�
�e of mortgagee or conVact seller �� -
Address of mortgagee or contred seller (number and st2 , city, state, ZI
Name of assignee or other owner or holder of mortgage
Address of assignee (number and st2et, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for curtent year? � Yes❑ No
COUNTY AUDITOR
Dedudion approved in the amount of:
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Signature Counry Auditor Date
' e certify under the penalty of perjury that the above and foregoing infortnation is true and corred and that ihe applicants was / were
sident of Indiana and owner of the aforementioned propeRy on March 1, 20
Signature wners full name) �/ Person authorized by duty executed Power of Attomey
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Ful resident address of applicant Address of authorized person
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