HomeMy WebLinkAboutMortgage_Finnerty/��'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
` � FOR DEDUCTION FROM ASSESSED VALUATION
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`� State Fwm 43709 (R6 / 506)
Presvibed by Depariment of Loml GovemmeM Finance
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INSTRUCTIONS:
Coun Township __.., ,. Year
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DEC 1 1 2006
File Mar1c
To be filed in person o� by mail with the CountyAuditor of the counfy where the property is located. ��
Filing Dates: 1) Real P�operty: Dunng the 12 months 6e%re ,lune �l of the yea� the deduction is to be eflectiv�
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 oI the yearotlhges��u4c��fo�pe79@l�ive.
See reverse side for additional instiuctions and pualifrcations.
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Applicant (owner or contra 6uyer- see restncGons on reverse side �- �'
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Taxing Distrid Key number / iegal description Re rd number Q/
L �4-.�t-,�o�-�a�:aa�-ca� �o
QO� � �� "'�/ _ fy\ Page number �� �O
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Asses d value of real property as of Mortgage / Contract indebledness unpaid as of Is the applicant the sole legal or equitable
March t, current year March 1, current year ownef? ❑ Yes ❑ No
If no, what is his / her exact share of inleresl? If owned with someone other than spouse, indicate with whom.
If name on record is different than that ot applicant, indicate below: Is the property in question:
❑ Real Property ❑ Moble Home pC 61.1-�
me of mortgagee or contred seller ��
Address of mortgagee or conVad selier (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and st2et, city, state, ZIP code)
Does applicant own property in any other If yes, what counry? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for current year? � Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amounl of:
20 �� 20 �� 20 i��i 20 20 20 20
1
Signature County Auditor pc Date
5�i0 4 5��01a_1tf
�/ We certify under lhe penalty of perjury that the above and foregoing information is lrue and corred and lhal lhe applicants was / were
a resid of Indiana and owner of the aforementioned property on March 1, 20
atur owners fuil name) Person authorized by duly executed Power of Attomey
or by IC 6-7.1-12-.07
Fu i Qqt ad ss of appli n � � Address of authorized person
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