HomeMy WebLinkAboutMortgage_Elpers (15).a=-�•nP STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS o T ns p Year
r,x.., _= FOR DEDUCTION FROM ASSESSED VAlUAT10N
Siate Form 43709 (RB / 2-07)
�s ' Presoibed by DeOaM1ment of Local Govemmenl Finance '�'i`l�
File Mark
INSTRUCTIONS: �
To be filed in person o� by maB wdh Ure CountyAuditor o7 the county where the pmpeAy is located. �p
Fding Dates: 7) Real Property: Dunng the 72 months be{ore June 1 f ol the year fhe deducGon is to be e8ec6ve. !� �`� � p�p�TOR
2J Mobile Hwnes assessed under IC 6-1.1-7: Behveen January 15 and MarcFr 2 o7fhe year the deducti "y�0�t1ECLVe.
See reverse side /w addifional insWctions and qualificafions. G�BS�
nppram �own r w ctnuyer - see re cuons m�ve sai
atlng Oistria Key number / legal des
O �o - �'J' ' l
rahie af real popnty as of Martli 1. artenl year Mortg
W R2fl
;, what is his I tw exacl shara of interest?
If name m record is OiYeren� Nan Ihat of applicanl, indifale below:
Name af morigagee or corylqU seller , .
Address of rtrortgagee n
Name
streef. dty, sfate. arMZlPCOee)
mortgage
ary. s�ate. ann ur moe�
Does applicaM own property in any dher
counly in Indiara�
❑ Yes ❑ No
�-1 T���
Deduction apprwed in ihe amounl of:
20 �� 20 _
as of MarU 1,
number � Page number
Is Ihe appfimnl Ilm sde legal w equiiable ovrtieR
�`^' I y�es ❑ No
/ -
If oaned with someone W�er Ihan spouse, indicate vrith whom.
If yes, what counry? Whal Taxing Distric
COUNTYAUDITOR �
20 _ 20 20
County
Is �he property in Question:
� Real Property ❑ Mobile Horre (IC G7.
f
•
����ti,_ I� I • �_,�
W ��S
$9 cc0. pO—'-
�gy �4.0 �!� u140h
ac��- �9s3
20 _ 20
Dafe (monlh. day, yea�
I I We certify under Ihe penalry of perjury that Me above and foregoing infomialion is Vue and correU and tliat the applicants was / were a resident of
Indiana and owner of the aforementioned property on March 1, 20
sLeet. dty. state. and ZIP code)
autha¢ed by duty exeated Paver of Attomey or by IC 61.1
Address ot aulhor¢e0 pason (number and s4eeL city, sfafe, aM ZIP wde)
Date (monfh, Oay, yea�
Oale (mmlh, day, yea�