HomeMy WebLinkAboutMortgage_Bartley (2)f� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'' FOR DEDUCTION FROM ASSESSED VALUATION
��l• State Form 43709 (R6I5-06)
Presaibed by �epeNnenl of local Govemmmt Finance
�9.�,e-�2.c� s - IE' - 2'° ° �
oun _ Townshi 33 Year
_
INSTRUCTIONS: DEC O FY�e�( p�
To be (led in person or by mail with the CountyAuditor o/ the county where the property is located. �-y,,
Filing Dates: 1) Real PropeRy: Dunng the 12 months before June I1 of the year the deduction is to be eff�ctl �
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 2 of th���e�� a' �be effective.
OR
See reverse side for additional instrucG'ons and quali�cations.
orcontractbuyer
Taxing
As�sed value of real property as of
March 1, curtent year
on
Key number / legal l�scription f
�G a13 �3 aoro— 06/ ��3 -a�
���/���-� F
MoRgage / Contrad indebtedness unpaid as of
March 1, current year
number
is me appupm me soie iegai or
owner? ❑ Yes ❑ No
� //�, � 117, 5�6 I
is his / her exad share of interest? If owned with someone other than s
pouse, indicate with whom.
If name on record is diiferent ihan that of aoolicant. indicate below:
�me of mortgagee or conVad seller //� �
d
Address of mortgagee or contred seller (number a d street, dty, state, ZIP
Name of assignee or other owner or halder of mortgage
Address of assignee (num6er and street, city, state, ZIP
Does applicaM own property in arry other I If yes, what county?
county in Indiana? _ ... - -
Dra���cr NO a401°.:.�.3.33 '
zo_
Signature
C�rd NO . .....................
�/l7, � ���. av
� � I
What Taxing Dislrid?
COUNTY AUDITOR
2�
County Auditor
20
Is the property
❑ Real Proper
❑ Moble Hane (IC Gt.
Has lhis deduction been requested on
property for current yeaR ❑ Yes ❑ No
20
Dale
20
We certify under the penalty of perjury that the above and foregoing information is true and correcl and that ihe applicants was / were
resident of Indiana and owner of the aforementioned properiy on March t, 20
Signatu (o�ynets full a�
� �(.Lg�?�
Fu resident address of a�
�` �R-#� ��c 7sw
��b5f�r � ti y��a �
Person authorized by duly executed Power ot Attomey
or by IC 6-1.1-12-.07
of authorized person