HomeMy WebLinkAboutMortgage_Alston (2)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township vear
� � State Form 43709 (R4 / 10-Ot )
"'. '�'-\
�PrperiDeO by Departmenl o/ Loral Govemment Finan[e `�
1
wsrRUCnorvs: APR 1F1��9U9
To be filed in person or by mail with the County Auditor ol the county where the property is located.
Filing Dates: 1) Real Property: During the 12 monfAs be%2 May 11 0/ the year the deduction is to �eHective.
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and Ma�ch 31 of th�year the �� n is to ba e ective.
See ieverse side foradditional instructions and qualifications GIBSON 6JUNTV AUDi?OR
or contract
on reverse side)
)" rid / Key number! legal descri/pt'ion
i.r���[/�' � ! ' l"'�J / � �� �Q
ed value of real property as of
1, curtent year
Ii no, what is his / her exact share of interest?
March 1, currenl y/ar� DO /�DAi
C/
name on record is different ihan that of applicant, indicate below:
of mortgagee or contrad seller
Address of mortgagee or contract seller
pty�
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and s6eet, city, state, ZIP code)
Does applipnt own property in any other If yes, what county?
county in Indiana?
Dedudion approved in the amount of:
20
Signature
20
as
Record number
Page number
Is the applicant the sole9egal or
owne(7 ❑ Yes ❑ No
owned with someone other than spouse, indicate with whom.
❑ Real ProperN ❑ Mobile Home OC Cr1.
ZIP
��-�a9 -
what7axing DI'awCl' NO..........'........� �n
� No
COUNTY AUDITOR
20 20 /`,� 20
County Auditor
._ :
Card 1�70 . .....................
• �. '..
�
20 ��
�
/ We certify under the penalty of perjury that the above and foregoing information is true and correcl and that the applicants was / were
� resident of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
:nt address of applipnt Address of authorized person
I ,BoX 3y7 . z�„0,���� �_