HomeMy WebLinkAboutMortgage_Kylee�'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
i� � FOR DEDUCTION FROM ASSESSED VALUATION
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/ Stata Fortn 43709 (R6 / 5-06)
� Presai6ed by Daperiment of Local Govemment Finance
INSTRUCTIONS:
Coun Township Year
�� File p�12rX �
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To be Fled in person or by mail with the County Audito� o/ the county where the p�opeRy is located.
Filing Dates: i) Real Property: During the 12 months before June I1 of the year the deduc6on is to be elfec6ve..
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 and March 2 of the year t(�,(�dqct�n.j�,tp,be ef/ective.
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See reverse side foi adddiona/ instn�ctions and oualifications
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Applicant (ownerorcont t buyer-see restricti ns on re se side) IBSON COUNTY qUDITOR
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Taxing DisVict Key number / legal description Record number
�e number
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Asse ed value oi real property as of MoRgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitabie
March 1, current year March 1, current year owner? Q Yes � No
f 5ood�
If no, what is his / her exact share oi interest? If ovmed with someone other than spouse, indicate with whom.
If name on record is different than that oi applicant, indicate below: Is the property in questlon:
❑ Real PropeAy � Mob7e Home QC G7.1-7)
ame of mortgagee or contract seller
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Address of moRgagee or conVact seller (number and street, city, s fe, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and sbeet, city, state, ZIP code)
Does applicant own property in any other Ii yes, what county? What Taxing District? Has this deducdon been requested on
wunty in indiana? property for current year? Q Yes❑ No
COUNTY AUDITOR
DeducGon approved in the amount of:
20 �`� 20 Q� 20 � 20 20 20 20
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Signature County Auditor Date
I/ We certity under the penalty of perjury that the above and foregoing information is true and correct and ihat the applicants was 1 were
�sident of In ' a and owner oi the forementioned property on March t, 20 .
nat e(own �1u11 n Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
Full re ' e dress oi appl' � Address oi authorized person
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