HomeMy WebLinkAboutMortgage_Harris (4)��" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' = FOR DEDUCTION FROM ASSESSED VALUATION Cou��rn��� JJJ�� r'�;Towns�h,,ip.J� �--�Year
S «. � State Portn 43709 (R4 / 70-07) � � �+ ' .
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� Prescribed by Department of Loral Govemment Finance
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INSTRUCTIONS: File Marli'
To 6e filed in person or by mail wifh fhe County Auditor of the county whe�e the property is located.
Filing Dates: 1) Real Prope}ty: Dunng lhe 12 months betore May f 1 of the year the deduction is to be e e ��e�N O�'TY AI�DITnR �
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 of the yeai tlie deduction is fo 6e eHective.
See reverse side (or additional instructions and qualifrca6ons.
Applica (owner contract buyer- see restnct n on �everse si }
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Taxing Distri ey number / legal description Record number �
OO�/� � �J/ � Page number �
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As ssed value of real property as of MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
M rch 1, wrrent year March 1, wrrent year owne(? ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is difterent than that of applicant, indicate below: Is lhe property in queslion:
❑ Real Property ❑ Mobile Home pC Fr1.1-�
�eme of mortgagee or contraIX seller
Address of mortgagee or contrad seller (number and stree city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and st2et, city, state, ZIP code) a
Does applipnt own propeRy in any other If yes, what county? Whal Taxing Distrid? Has this dedudion een requested on
county in Indiana? property for current yeaf? 0 Yes� No
COUNTY AUDITOR
Deduclion approved in the amount of:
zo O 3 za zo Zo �L Zo �Z Zo Q� zo �
tFB D P Id 1�
Signature County Auditor Date
�/ We certiy under the penalty of perjury that the above and foregoing informalion is true and corred and that the applicants was / were
�resident of diana and owner of the aforementioned property on March 1, 20
Signa re wne/s full n e) Person authorized by duly executed Power of Attomey
� or by IC 6-1.1-12-.07
Fu�s� ent address of app �cant Address of authorized person