HomeMy WebLinkAboutMortgage_Juilan (3)�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS u s'p vear
' FOR DEDUCTION FROM ASSESSED VALUATION
'�. / State Fortn d3709 (R6/ 5-06)
'«• Presmbed by Oepartment of local Govemment Finance O�'100�
� L
INSTRUCTIONS: Fil�
To be �led in person or by mail with the County Auditor of the county whe�e the propeRy is located. �7 Q pITOR
Filing Dates: 1) Real Property: During tf�e 12 months before June 17 of the year the deduction is to be �,g��.COUNTY AU
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and Maich 2 ot the ye 8ie deduc6on is fo be eflectrve.
See reverse side for additional instructions and qualifications.
Appli � t(owne� or contrac�uyer see styctions on reve�se side)
Taxing District Key number / legal description Record number
0 �
p�y�, Page number
1�-aa-i3-aoo-a�i.4Z5-� �.a3 �
A essed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owner? Q Yes � No
I � �
If no, what is his / her exact share of interest? If owned with someone otlier than spouse, indicate with whom.
If name on record is difterent than that of applicant, indiqte below: Is the property in question:
eal Property � Mob7e Home (IC 61.1-7)
Name of mortgagee or contract seller
Address of moRgagee or contract seller (number and st ., ci(y, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does appliqnt own properry in any other If yes, what counry? What Taxing DistricY? Has this deduc6on been requested on
county in Indiana? property for curtent year? ❑ YesO No
� I3 ��-I — I COUNTY AUDITOR
Deduction approved in fhe amount of:
20 �� 20 Q� 20 �� 20 20 20 20
� �
Signature County Auditor Date
I I We certify under the penalty of perjury that the above and foregoing infortnation is true and corteci and that the applican4s was / were
�sident of Indiana and owner of the aforementioned property on March 1, 20 �
,,.�natu e(owners full name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
Full sident address f applicant Address of auihorized person
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