HomeMy WebLinkAboutMortgage_Martin (3)�;�'� 4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS , I,
FOR DEDUCTION FROM ASSESSED VALUATION Year
r_ / State Form 43709 (R6 / SO6)
� PresvibedbyDeparimentofLOplGmemmemFinarice MAR u ���i�j
INSTRUCTIONS: ' � C/ �F�Mark
To be filed in person or by mail with the CountyAuditor of the county whe�e the p�operty is Ioca��SON COUNTY AUDITOR
Filing Dates: 1J Real Property: During the 12 months before ,lune I1 of the yea� the deduction is to be eflective.
2) Mobile Homes assessed under IC 6-7.1-7: Between January 15 and March 2 0/ the year the deducG'on is to be elfective.
See reverse side for additional instructions and qualrficafions.
Applicant (owner or conhact buyer- see st ''ons on rev e side)
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Taxing 'strid Key number / legal description Record number
� n- Page number
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Asse ed value of real property as of MoAgage / Contrad indebtedness unpaid as of Is the applican he sole legal or equitable
March t, current year March 1, currenl year ownert s❑ No
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If no, what is his / her exad share of interesl? If owned with someone other than spouse, indicate with whom.
If name on record is diflerent than that of applicant, indicate below: I the property in question:
Property ❑ Mabile Home pC 61.1-�
e of mortgagee or contrad selle -
Address of mortgagee or wntred seller (number and sfreet, city, state, ZIP � ... •�••••
Dra�vcr \0... .. •
Name of assignee or other owner or holder of mortgage _ ,,,,,,,,,.
Card �O. ...).�
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Address of assignee (number and street, ciry, state, ZIP code)
Dces applicant own property in any other If yes, what county? What Tauing Distrid? Has this dedudion been requested on
county in Indiana? property for current year? � Yes ❑ No
_ �3 - C�_�� COUNTY AUDITOR C
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Deduction approved in the amount of:
20 �� 20 04 20 20 20 20 20
1 �
Signature County Auditor Dale
We certiy under lhe penalry of perjury that the above and foregoing information is true and corred and lhat the applicants was / were
sident of Indiana and owner of the aforementioned property on March 1, 20
Signat (owners lull name) Person authorized by duly executed Power of Attomey
� • or by IC 6-1.1-12-.07
Full reside� a dr s o�p�lo nS Address of authorized person
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