HomeMy WebLinkAboutMortgage_Elpers (13)`�� STATEMIENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION yyy Township Year
� w� / State Form 63709 (R514-03) � '
Prescn0etl �y Departmeni of local Govemment Finance
SEP 0 8 1� �5
INSTRUCTIONS: File �
To be filed in person or by mail with the County Auditor of fhe county where the property is located. `-y,,
Filing Dates: 1J Real Property: During the 12 months before May 11 o/the year the deduction is to be eRectl✓� �f
2) Mobile Homes assessed under IC 6-1.1-7: Between Janua 15 and Ma�ch 2 0! th Q�� to be elfective.
. ry ���h'C.v0�i9�1 DITOR
See reverse side for additional instructions and qualifications.
Appucant (owner �contracf buyer - see resfnctions on reverse side)
- �- m �
Taxing Distrid Ke mber / legal description
oo�-b ab�
Assessed lue of real property as of Mortgage / Contract indebtedness
March 1, current year March 1, current year
/ �// / V v'�
If no, what is his / her exact share of interest?
If name on record is different ihan thai of applicant,
of mortgagee or contract seller
S�
Address of mortgagee or contraa seiler (number and street, city,
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand st2et, city, state, ZIP
Does applipnt own property in any other If yes, what counry?
county in Indiana?
Deduction approved in the amount of:
zo n i i i zo
�
ZIP
number
^ \ Page number �
�� o
ipaid as of Is the applicant the sole legal or equftable
owner? ❑ Yes ❑ No
with someone other than spouse, indicate with whom.
What Taxing District?
COUNTY AUDITOR
20 D� 20 20
�
County Auditor
s the property in question:
❑ Real Property ❑ Mobile Home (IC 61.1-�
Has this deduclion been requested on
property for current year? � Yes ❑ No
zo
Date
zo
We certify under the penalty of peryury that the above and foregoing information is irue and corred and thal ihe applicants was / were
�esident of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Atlomey
or by IC 6-t.t-12-.07
of authorized person
47639