HomeMy WebLinkAboutMortgage_Mayer (2)`° R'�' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
i�"` �: FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
_S J Slale Form 43709 (R4 / 70-Ot)
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Prescribe0 by Departnent ol Local Govemment Fnance
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INSTRUCTIONS: � p � '�le ar
To be �led in person or by mail with the County Auditor o( lhe county whe2 the property is I ted.�� ��1
Filing Dates: 1) Real Property: Dunng the 12 months be/ore May 11 o/the year the deduction is to ���eC�ti� .'n(1�
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 of th r fbe.d�klbt+on is to be eflective.
See reverse side for additional inst�ucfions and qualifications. l` , // „ �
Applicant (owner or contract buyer
Distrid
on
Key number / legal
Record
O � Q��O( � O r1 Page number �/—
\� \.! Q ,t.
I value ot real property as of Mortgage / Contrect indebtedness unpaid as of Is the applicant the sole legal or equitable
current year March 1, current year owne(? ❑ Yes ❑ No
�0/, 50�
Ii no, what is his / her exad share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than lhat of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home QC 61.
�me of mortgagee or contract seller /^— �
J
Address of mortgagee or contracl seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
of assignee (num6er and street, city, state, ZIP code)
Does applicant own property in any other If yes, what wunry? What Taxing District?
county in Indiana?
Deduction approved in the amount of:
20�_ 20
Qi,
SignaWre
COUNTY AUDITOR
20 �� 20 �i� 20 O
/
County Auditar
Has this deduction been requested on
properly for current year? Q Yes ❑ No
20 �_ � 20 �
We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 7, 20
(owners
or by IC 6-1.1-12-.07
executed Power of Atforney
resident address 6Yapplicant / �Address of authorized person