HomeMy WebLinkAboutMortgage_Pfeffer (3)�s-�
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STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Form I3709 (R3 / 70-00)
PreWibeO �y State Boartl of Tax Commissianers
InsVuctions for fiiing:
To be filed in person or by mail with the County Auditor of the county where the property is
located during the 12 months before May 11 of the year lhe dedudion is to be effedive. See _
reverse side for additional insWdions and qualfiptions.
FORM 5
Coun Township Year
File Mark
JUN 27 2001
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Applicant (owner tract buyer- see 2' �o rev rs sid ) ' . .
Taxing Disfid Key number / legal scription Record number �/
^ ,��„� � O/ 2-00�//'//_�i Page number �9 n
CL{,�� � rJ r" �
essed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curtent year MarcFi 1, curre t year owneR ❑ Yes ❑ No
�3 �O O C�.
If no, what is his / her exad share of interest? f owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: '
�e of mortgagee or contrad seller
Address of mortgagee or conVad seller (number and re t, city, state, ZIP ,
Name of assignee or other owner or holder of mortgage
Address of assignee (number and shaet, aty, state, ZIP code)
Does applipnt own real property in any If yes, what county? 1/Vhat Ta�cing DisUid? Has this dedudion been requested on
other county in Indiana? property for wrrent yeaR� Yes❑ No
COUNTY AUDITOR
Dedudion approved in the amounf of:
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Signature County Auditor Date
� We ceRify under the penalty of perjury that the above and foregoing infortnation is true and cortecf and thal the applicants was / were
J •ident of Indiana and owner of the aforementloned property on March 1, 20
Signature ners full name Person authorized by duly executed Power of Attomey
or by IC 61.1-12-.07
II"residen address of a li Address of author¢ed person
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